|
HC RECOVERY 1 EA MIN
|
Facility
|
IP
|
$15.30
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$15.30 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: ASR ASR |
$14.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.56
|
| Rate for Payer: BCN Commercial |
$12.56
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$14.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$14.84
|
| Rate for Payer: Healthscope Whirlpool |
$15.30
|
| Rate for Payer: Mclaren Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.46
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
IP
|
$378.09
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$283.57 |
| Max. Negotiated Rate |
$378.09 |
| Rate for Payer: Aetna Commercial |
$340.28
|
| Rate for Payer: ASR ASR |
$366.75
|
| Rate for Payer: BCBS Trust/PPO |
$310.49
|
| Rate for Payer: BCN Commercial |
$310.49
|
| Rate for Payer: Cash Price |
$302.47
|
| Rate for Payer: Cofinity Commercial |
$355.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.47
|
| Rate for Payer: Healthscope Commercial |
$366.75
|
| Rate for Payer: Healthscope Whirlpool |
$378.09
|
| Rate for Payer: Mclaren Commercial |
$340.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.38
|
| Rate for Payer: Nomi Health Commercial |
$310.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.72
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
OP
|
$378.09
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$139.89 |
| Max. Negotiated Rate |
$378.09 |
| Rate for Payer: Aetna Commercial |
$340.28
|
| Rate for Payer: Aetna Medicare |
$139.89
|
| Rate for Payer: ASR ASR |
$366.75
|
| Rate for Payer: BCBS Complete |
$151.24
|
| Rate for Payer: BCBS Trust/PPO |
$311.74
|
| Rate for Payer: BCN Commercial |
$311.74
|
| Rate for Payer: Cash Price |
$302.47
|
| Rate for Payer: Cofinity Commercial |
$355.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.47
|
| Rate for Payer: Healthscope Commercial |
$366.75
|
| Rate for Payer: Healthscope Whirlpool |
$378.09
|
| Rate for Payer: Mclaren Commercial |
$340.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.38
|
| Rate for Payer: Nomi Health Commercial |
$310.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$331.28
|
| Rate for Payer: Priority Health Narrow Network |
$265.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$332.72
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
IP
|
$187.51
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$140.63 |
| Max. Negotiated Rate |
$187.51 |
| Rate for Payer: Aetna Commercial |
$168.76
|
| Rate for Payer: ASR ASR |
$181.88
|
| Rate for Payer: BCBS Trust/PPO |
$153.98
|
| Rate for Payer: BCN Commercial |
$153.98
|
| Rate for Payer: Cash Price |
$150.01
|
| Rate for Payer: Cofinity Commercial |
$176.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.01
|
| Rate for Payer: Healthscope Commercial |
$181.88
|
| Rate for Payer: Healthscope Whirlpool |
$187.51
|
| Rate for Payer: Mclaren Commercial |
$168.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.38
|
| Rate for Payer: Nomi Health Commercial |
$153.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.01
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
OP
|
$187.51
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$187.51 |
| Rate for Payer: Aetna Commercial |
$168.76
|
| Rate for Payer: Aetna Medicare |
$69.38
|
| Rate for Payer: ASR ASR |
$181.88
|
| Rate for Payer: BCBS Complete |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$154.60
|
| Rate for Payer: BCN Commercial |
$154.60
|
| Rate for Payer: Cash Price |
$150.01
|
| Rate for Payer: Cofinity Commercial |
$176.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.01
|
| Rate for Payer: Healthscope Commercial |
$181.88
|
| Rate for Payer: Healthscope Whirlpool |
$187.51
|
| Rate for Payer: Mclaren Commercial |
$168.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.38
|
| Rate for Payer: Nomi Health Commercial |
$153.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$164.30
|
| Rate for Payer: Priority Health Narrow Network |
$131.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.01
|
|
|
HC RECOVERY 2 BASE CHARGE
|
Facility
|
OP
|
$98.94
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: Aetna Commercial |
$89.05
|
| Rate for Payer: Aetna Medicare |
$36.61
|
| Rate for Payer: ASR ASR |
$95.97
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS Trust/PPO |
$81.58
|
| Rate for Payer: BCN Commercial |
$81.58
|
| Rate for Payer: Cash Price |
$79.15
|
| Rate for Payer: Cofinity Commercial |
$93.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.15
|
| Rate for Payer: Healthscope Commercial |
$95.97
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$89.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.10
|
| Rate for Payer: Nomi Health Commercial |
$81.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.69
|
| Rate for Payer: Priority Health Narrow Network |
$69.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.07
|
|
|
HC RECOVERY 2 BASE CHARGE
|
Facility
|
IP
|
$98.94
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$98.94 |
| Rate for Payer: Aetna Commercial |
$89.05
|
| Rate for Payer: ASR ASR |
$95.97
|
| Rate for Payer: BCBS Trust/PPO |
$81.25
|
| Rate for Payer: BCN Commercial |
$81.25
|
| Rate for Payer: Cash Price |
$79.15
|
| Rate for Payer: Cofinity Commercial |
$93.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.15
|
| Rate for Payer: Healthscope Commercial |
$95.97
|
| Rate for Payer: Healthscope Whirlpool |
$98.94
|
| Rate for Payer: Mclaren Commercial |
$89.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.10
|
| Rate for Payer: Nomi Health Commercial |
$81.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.07
|
|
|
HC RECOVERY 2 EA MIN
|
Facility
|
OP
|
$12.24
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: Aetna Medicare |
$4.53
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: BCBS Complete |
$4.90
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.87
|
| Rate for Payer: Healthscope Whirlpool |
$12.24
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.72
|
| Rate for Payer: Priority Health Narrow Network |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
|
HC RECOVERY 2 EA MIN
|
Facility
|
IP
|
$12.24
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Aetna Commercial |
$11.02
|
| Rate for Payer: ASR ASR |
$11.87
|
| Rate for Payer: BCBS Trust/PPO |
$10.05
|
| Rate for Payer: BCN Commercial |
$10.05
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.87
|
| Rate for Payer: Healthscope Whirlpool |
$12.24
|
| Rate for Payer: Mclaren Commercial |
$11.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.40
|
| Rate for Payer: Nomi Health Commercial |
$10.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.77
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
OP
|
$338.20
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$125.13 |
| Max. Negotiated Rate |
$338.20 |
| Rate for Payer: Aetna Commercial |
$304.38
|
| Rate for Payer: Aetna Medicare |
$125.13
|
| Rate for Payer: ASR ASR |
$328.05
|
| Rate for Payer: BCBS Complete |
$135.28
|
| Rate for Payer: BCBS Trust/PPO |
$278.85
|
| Rate for Payer: BCN Commercial |
$278.85
|
| Rate for Payer: Cash Price |
$270.56
|
| Rate for Payer: Cofinity Commercial |
$317.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.56
|
| Rate for Payer: Healthscope Commercial |
$328.05
|
| Rate for Payer: Healthscope Whirlpool |
$338.20
|
| Rate for Payer: Mclaren Commercial |
$304.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.47
|
| Rate for Payer: Nomi Health Commercial |
$277.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$296.33
|
| Rate for Payer: Priority Health Narrow Network |
$237.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.62
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
IP
|
$338.20
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$253.65 |
| Max. Negotiated Rate |
$338.20 |
| Rate for Payer: Aetna Commercial |
$304.38
|
| Rate for Payer: ASR ASR |
$328.05
|
| Rate for Payer: BCBS Trust/PPO |
$277.73
|
| Rate for Payer: BCN Commercial |
$277.73
|
| Rate for Payer: Cash Price |
$270.56
|
| Rate for Payer: Cofinity Commercial |
$317.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.56
|
| Rate for Payer: Healthscope Commercial |
$328.05
|
| Rate for Payer: Healthscope Whirlpool |
$338.20
|
| Rate for Payer: Mclaren Commercial |
$304.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.47
|
| Rate for Payer: Nomi Health Commercial |
$277.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$297.62
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
OP
|
$104.21
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$104.21 |
| Rate for Payer: Aetna Commercial |
$93.79
|
| Rate for Payer: Aetna Medicare |
$38.56
|
| Rate for Payer: ASR ASR |
$101.08
|
| Rate for Payer: BCBS Complete |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$85.92
|
| Rate for Payer: BCN Commercial |
$85.92
|
| Rate for Payer: Cash Price |
$83.37
|
| Rate for Payer: Cofinity Commercial |
$97.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.37
|
| Rate for Payer: Healthscope Commercial |
$101.08
|
| Rate for Payer: Healthscope Whirlpool |
$104.21
|
| Rate for Payer: Mclaren Commercial |
$93.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.58
|
| Rate for Payer: Nomi Health Commercial |
$85.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.31
|
| Rate for Payer: Priority Health Narrow Network |
$73.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.70
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
IP
|
$104.21
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$78.16 |
| Max. Negotiated Rate |
$104.21 |
| Rate for Payer: Aetna Commercial |
$93.79
|
| Rate for Payer: ASR ASR |
$101.08
|
| Rate for Payer: BCBS Trust/PPO |
$85.58
|
| Rate for Payer: BCN Commercial |
$85.58
|
| Rate for Payer: Cash Price |
$83.37
|
| Rate for Payer: Cofinity Commercial |
$97.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.37
|
| Rate for Payer: Healthscope Commercial |
$101.08
|
| Rate for Payer: Healthscope Whirlpool |
$104.21
|
| Rate for Payer: Mclaren Commercial |
$93.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.58
|
| Rate for Payer: Nomi Health Commercial |
$85.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.70
|
|
|
HC RECOVERY 3 BASE CHARGE
|
Facility
|
IP
|
$63.00
|
|
| Hospital Charge Code |
71000040
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$56.70
|
| Rate for Payer: ASR ASR |
$61.11
|
| Rate for Payer: BCBS Trust/PPO |
$51.74
|
| Rate for Payer: BCN Commercial |
$51.74
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$59.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Healthscope Commercial |
$61.11
|
| Rate for Payer: Healthscope Whirlpool |
$63.00
|
| Rate for Payer: Mclaren Commercial |
$56.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.55
|
| Rate for Payer: Nomi Health Commercial |
$51.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.44
|
|
|
HC RECOVERY 3 BASE CHARGE
|
Facility
|
OP
|
$63.00
|
|
| Hospital Charge Code |
71000040
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$23.31 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$56.70
|
| Rate for Payer: Aetna Medicare |
$23.31
|
| Rate for Payer: ASR ASR |
$61.11
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$51.94
|
| Rate for Payer: BCN Commercial |
$51.94
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$59.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Healthscope Commercial |
$61.11
|
| Rate for Payer: Healthscope Whirlpool |
$63.00
|
| Rate for Payer: Mclaren Commercial |
$56.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.55
|
| Rate for Payer: Nomi Health Commercial |
$51.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.20
|
| Rate for Payer: Priority Health Narrow Network |
$44.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.44
|
|
|
HC RECOVERY 3 EA MIN
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$6.88 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.26
|
| Rate for Payer: ASR ASR |
$8.90
|
| Rate for Payer: BCBS Trust/PPO |
$7.54
|
| Rate for Payer: BCN Commercial |
$7.54
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$8.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.90
|
| Rate for Payer: Healthscope Whirlpool |
$9.18
|
| Rate for Payer: Mclaren Commercial |
$8.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.08
|
|
|
HC RECOVERY 3 EA MIN
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.26
|
| Rate for Payer: Aetna Medicare |
$3.40
|
| Rate for Payer: ASR ASR |
$8.90
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS Trust/PPO |
$7.57
|
| Rate for Payer: BCN Commercial |
$7.57
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$8.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.90
|
| Rate for Payer: Healthscope Whirlpool |
$9.18
|
| Rate for Payer: Mclaren Commercial |
$8.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$8.04
|
| Rate for Payer: Priority Health Narrow Network |
$6.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.08
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
OP
|
$210.56
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$77.91 |
| Max. Negotiated Rate |
$210.56 |
| Rate for Payer: Aetna Commercial |
$189.50
|
| Rate for Payer: Aetna Medicare |
$77.91
|
| Rate for Payer: ASR ASR |
$204.24
|
| Rate for Payer: BCBS Complete |
$84.22
|
| Rate for Payer: BCBS Trust/PPO |
$173.61
|
| Rate for Payer: BCN Commercial |
$173.61
|
| Rate for Payer: Cash Price |
$168.45
|
| Rate for Payer: Cofinity Commercial |
$197.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.45
|
| Rate for Payer: Healthscope Commercial |
$204.24
|
| Rate for Payer: Healthscope Whirlpool |
$210.56
|
| Rate for Payer: Mclaren Commercial |
$189.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.98
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.49
|
| Rate for Payer: Priority Health Narrow Network |
$147.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.29
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
IP
|
$210.56
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$157.92 |
| Max. Negotiated Rate |
$210.56 |
| Rate for Payer: Aetna Commercial |
$189.50
|
| Rate for Payer: ASR ASR |
$204.24
|
| Rate for Payer: BCBS Trust/PPO |
$172.91
|
| Rate for Payer: BCN Commercial |
$172.91
|
| Rate for Payer: Cash Price |
$168.45
|
| Rate for Payer: Cofinity Commercial |
$197.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.45
|
| Rate for Payer: Healthscope Commercial |
$204.24
|
| Rate for Payer: Healthscope Whirlpool |
$210.56
|
| Rate for Payer: Mclaren Commercial |
$189.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.98
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.29
|
|
|
HC RED CEDAR IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$22.69
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$18.16
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC RED CEDAR IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.43 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: ASR ASR |
$25.12
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$24.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$25.12
|
| Rate for Payer: Healthscope Whirlpool |
$25.90
|
| Rate for Payer: Mclaren Commercial |
$23.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.79
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
IP
|
$331.53
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$248.65 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: ASR ASR |
$321.58
|
| Rate for Payer: BCBS Trust/PPO |
$272.25
|
| Rate for Payer: BCN Commercial |
$272.25
|
| Rate for Payer: Cash Price |
$265.22
|
| Rate for Payer: Cofinity Commercial |
$311.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.22
|
| Rate for Payer: Healthscope Commercial |
$321.58
|
| Rate for Payer: Healthscope Whirlpool |
$331.53
|
| Rate for Payer: Mclaren Commercial |
$298.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.80
|
| Rate for Payer: Nomi Health Commercial |
$271.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.75
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
OP
|
$331.53
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$96.86 |
| Max. Negotiated Rate |
$632.87 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna Medicare |
$185.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.50
|
| Rate for Payer: ASR ASR |
$321.58
|
| Rate for Payer: BCBS Complete |
$101.71
|
| Rate for Payer: BCBS MAPPO |
$185.20
|
| Rate for Payer: BCBS Trust/PPO |
$273.35
|
| Rate for Payer: BCN Commercial |
$273.35
|
| Rate for Payer: BCN Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$265.22
|
| Rate for Payer: Cash Price |
$265.22
|
| Rate for Payer: Cofinity Commercial |
$311.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.20
|
| Rate for Payer: Healthscope Commercial |
$321.58
|
| Rate for Payer: Healthscope Whirlpool |
$331.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$185.20
|
| Rate for Payer: Mclaren Commercial |
$298.38
|
| Rate for Payer: Mclaren Medicaid |
$185.20
|
| Rate for Payer: Mclaren Medicare |
$185.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.46
|
| Rate for Payer: Meridian Medicaid |
$101.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.80
|
| Rate for Payer: Nomi Health Commercial |
$271.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.65
|
| Rate for Payer: PACE Medicare |
$175.94
|
| Rate for Payer: PACE SWMI |
$185.20
|
| Rate for Payer: PHP Commercial |
$203.72
|
| Rate for Payer: PHP Medicaid |
$99.27
|
| Rate for Payer: PHP Medicare Advantage |
$185.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$632.87
|
| Rate for Payer: Priority Health Medicare |
$185.20
|
| Rate for Payer: Priority Health Narrow Network |
$506.29
|
| Rate for Payer: Railroad Medicare Medicare |
$185.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$291.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.20
|
| Rate for Payer: UHC Exchange |
$287.06
|
| Rate for Payer: UHC Medicaid |
$96.86
|
| Rate for Payer: UHCCP DNSP |
$185.20
|
| Rate for Payer: UHCCP Medicaid |
$96.86
|
| Rate for Payer: VA VA |
$185.20
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
OP
|
$238.68
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.31 |
| Max. Negotiated Rate |
$238.68 |
| Rate for Payer: Aetna Commercial |
$214.81
|
| Rate for Payer: Aetna Medicare |
$88.31
|
| Rate for Payer: ASR ASR |
$231.52
|
| Rate for Payer: BCBS Complete |
$95.47
|
| Rate for Payer: BCBS Trust/PPO |
$196.79
|
| Rate for Payer: BCN Commercial |
$196.79
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$224.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Healthscope Commercial |
$231.52
|
| Rate for Payer: Healthscope Whirlpool |
$238.68
|
| Rate for Payer: Mclaren Commercial |
$214.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.13
|
| Rate for Payer: Priority Health Narrow Network |
$167.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.04
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
IP
|
$238.68
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$179.01 |
| Max. Negotiated Rate |
$238.68 |
| Rate for Payer: Aetna Commercial |
$214.81
|
| Rate for Payer: ASR ASR |
$231.52
|
| Rate for Payer: BCBS Trust/PPO |
$196.00
|
| Rate for Payer: BCN Commercial |
$196.00
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$224.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Healthscope Commercial |
$231.52
|
| Rate for Payer: Healthscope Whirlpool |
$238.68
|
| Rate for Payer: Mclaren Commercial |
$214.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$210.04
|
|
