|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$6,030.46
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,063.17 |
| Max. Negotiated Rate |
$5,427.41 |
| Rate for Payer: Aetna Commercial |
$5,125.89
|
| Rate for Payer: Aetna Medicare |
$1,567.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,884.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,884.52
|
| Rate for Payer: BCBS Complete |
$1,116.24
|
| Rate for Payer: BCBS MAPPO |
$1,507.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,957.64
|
| Rate for Payer: BCN Commercial |
$4,957.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,507.62
|
| Rate for Payer: Cash Price |
$4,824.37
|
| Rate for Payer: Cofinity Commercial |
$5,186.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,824.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,507.62
|
| Rate for Payer: Healthscope Commercial |
$5,427.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,522.85
|
| Rate for Payer: Mclaren Medicaid |
$1,063.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,583.00
|
| Rate for Payer: Meridian Medicaid |
$1,116.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,733.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,658.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,125.89
|
| Rate for Payer: Nomi Health Commercial |
$4,944.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,522.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,432.23
|
| Rate for Payer: PACE SWMI |
$1,507.62
|
| Rate for Payer: PHP Commercial |
$5,125.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,507.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,246.50
|
| Rate for Payer: Priority Health Medicare |
$1,522.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,197.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,507.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,306.80
|
| Rate for Payer: UHC Core |
$5,035.43
|
| Rate for Payer: UHC Exchange |
$1,507.62
|
| Rate for Payer: UHC Medicaid |
$1,063.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,507.62
|
| Rate for Payer: UHCCP Medicaid |
$1,063.17
|
| Rate for Payer: VA VA |
$1,507.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,522.85
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$6,030.46
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,197.20 |
| Max. Negotiated Rate |
$5,427.41 |
| Rate for Payer: Aetna Commercial |
$5,125.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,980.56
|
| Rate for Payer: BCN Commercial |
$4,980.56
|
| Rate for Payer: Cash Price |
$4,824.37
|
| Rate for Payer: Cofinity Commercial |
$5,186.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,824.37
|
| Rate for Payer: Healthscope Commercial |
$5,427.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,522.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,125.89
|
| Rate for Payer: Nomi Health Commercial |
$4,944.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,522.85
|
| Rate for Payer: PHP Commercial |
$5,125.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,246.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,197.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,306.80
|
| Rate for Payer: UHC Core |
$5,035.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,522.85
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,366.91
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,298.79 |
| Max. Negotiated Rate |
$6,630.22 |
| Rate for Payer: Aetna Commercial |
$6,261.87
|
| Rate for Payer: Aetna Medicare |
$1,915.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,302.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,302.16
|
| Rate for Payer: BCBS Complete |
$1,363.62
|
| Rate for Payer: BCBS MAPPO |
$1,841.73
|
| Rate for Payer: BCBS Trust/PPO |
$6,056.34
|
| Rate for Payer: BCN Commercial |
$6,056.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,841.73
|
| Rate for Payer: Cash Price |
$5,893.53
|
| Rate for Payer: Cofinity Commercial |
$6,335.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,841.73
|
| Rate for Payer: Healthscope Commercial |
$6,630.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,525.18
|
| Rate for Payer: Mclaren Medicaid |
$1,298.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,933.81
|
| Rate for Payer: Meridian Medicaid |
$1,363.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,117.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,025.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,261.87
|
| Rate for Payer: Nomi Health Commercial |
$6,040.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,749.64
|
| Rate for Payer: PACE SWMI |
$1,841.73
|
| Rate for Payer: PHP Commercial |
$6,261.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,841.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,298.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,409.21
|
| Rate for Payer: Priority Health Medicare |
$1,860.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,127.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,841.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,482.88
|
| Rate for Payer: UHC Core |
$6,151.37
|
| Rate for Payer: UHC Exchange |
$1,841.73
|
| Rate for Payer: UHC Medicaid |
$1,298.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,841.73
|
| Rate for Payer: UHCCP Medicaid |
$1,298.79
|
| Rate for Payer: VA VA |
$1,841.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,525.18
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,366.91
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,127.37 |
| Max. Negotiated Rate |
$6,630.22 |
| Rate for Payer: Aetna Commercial |
$6,261.87
|
| Rate for Payer: BCBS Trust/PPO |
$6,084.33
|
| Rate for Payer: BCN Commercial |
$6,084.33
|
| Rate for Payer: Cash Price |
$5,893.53
|
| Rate for Payer: Cofinity Commercial |
$6,335.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,893.53
|
| Rate for Payer: Healthscope Commercial |
$6,630.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,525.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,261.87
|
| Rate for Payer: Nomi Health Commercial |
$6,040.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,525.18
|
| Rate for Payer: PHP Commercial |
$6,261.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,409.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,127.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,482.88
|
| Rate for Payer: UHC Core |
$6,151.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,525.18
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.78 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$331.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.44
|
| Rate for Payer: BCBS Complete |
$236.00
|
| Rate for Payer: BCBS MAPPO |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.18
|
| Rate for Payer: BCN Commercial |
$1,048.18
|
| Rate for Payer: BCN Medicare Advantage |
$318.75
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Mclaren Medicaid |
$224.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.69
|
| Rate for Payer: Meridian Medicaid |
$236.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$350.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PACE Senior Care Partners |
$302.81
|
| Rate for Payer: PACE SWMI |
$318.75
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: PHP Medicare Advantage |
$318.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Medicare |
$321.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$887.40
|
| Rate for Payer: Railroad Medicare Medicare |
$318.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: UHC Exchange |
$318.75
|
| Rate for Payer: UHC Medicaid |
$224.78
|
| Rate for Payer: UHC Medicare Advantage |
$318.75
|
| Rate for Payer: UHCCP Medicaid |
$224.78
|
| Rate for Payer: VA VA |
$318.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$887.40 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,053.02
|
| Rate for Payer: BCN Commercial |
$1,053.02
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$956.25
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$887.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
IP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,109.25 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.28
|
| Rate for Payer: BCN Commercial |
$1,316.28
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,195.31
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
OP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.98 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: Aetna Medicare |
$414.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$498.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$498.05
|
| Rate for Payer: BCBS Complete |
$295.00
|
| Rate for Payer: BCBS MAPPO |
$398.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.22
|
| Rate for Payer: BCN Commercial |
$1,310.22
|
| Rate for Payer: BCN Medicare Advantage |
$398.44
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.44
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Mclaren Medicaid |
$280.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.36
|
| Rate for Payer: Meridian Medicaid |
$295.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,195.31
|
| Rate for Payer: PACE Senior Care Partners |
$378.52
|
| Rate for Payer: PACE SWMI |
$398.44
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: PHP Medicare Advantage |
$398.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Medicare |
$402.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.25
|
| Rate for Payer: Railroad Medicare Medicare |
$398.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: UHC Exchange |
$398.44
|
| Rate for Payer: UHC Medicaid |
$280.98
|
| Rate for Payer: UHC Medicare Advantage |
$398.44
|
| Rate for Payer: UHCCP Medicaid |
$280.98
|
| Rate for Payer: VA VA |
$398.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$6,137.71
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,271.85 |
| Max. Negotiated Rate |
$5,523.94 |
| Rate for Payer: Aetna Commercial |
$5,217.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,069.13
|
| Rate for Payer: BCN Commercial |
$5,069.13
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cofinity Commercial |
$5,278.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,910.17
|
| Rate for Payer: Healthscope Commercial |
$5,523.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,603.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,217.05
|
| Rate for Payer: Nomi Health Commercial |
$5,032.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,603.28
|
| Rate for Payer: PHP Commercial |
$5,217.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,339.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,271.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,401.18
|
| Rate for Payer: UHC Core |
$5,124.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,603.28
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$6,137.71
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,082.08 |
| Max. Negotiated Rate |
$5,523.94 |
| Rate for Payer: Aetna Commercial |
$5,217.05
|
| Rate for Payer: Aetna Medicare |
$1,595.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,918.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,918.03
|
| Rate for Payer: BCBS Complete |
$1,136.09
|
| Rate for Payer: BCBS MAPPO |
$1,534.43
|
| Rate for Payer: BCBS Trust/PPO |
$5,045.81
|
| Rate for Payer: BCN Commercial |
$5,045.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,534.43
|
| Rate for Payer: Cash Price |
$4,910.17
|
| Rate for Payer: Cofinity Commercial |
$5,278.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,910.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,534.43
|
| Rate for Payer: Healthscope Commercial |
$5,523.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,603.28
|
| Rate for Payer: Mclaren Medicaid |
$1,082.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,611.15
|
| Rate for Payer: Meridian Medicaid |
$1,136.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,764.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,687.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,217.05
|
| Rate for Payer: Nomi Health Commercial |
$5,032.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,603.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,457.71
|
| Rate for Payer: PACE SWMI |
$1,534.43
|
| Rate for Payer: PHP Commercial |
$5,217.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,534.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,339.81
|
| Rate for Payer: Priority Health Medicare |
$1,549.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,271.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,534.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,401.18
|
| Rate for Payer: UHC Core |
$5,124.99
|
| Rate for Payer: UHC Exchange |
$1,534.43
|
| Rate for Payer: UHC Medicaid |
$1,082.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,534.43
|
| Rate for Payer: UHCCP Medicaid |
$1,082.08
|
| Rate for Payer: VA VA |
$1,534.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,603.28
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$9,077.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,600.44 |
| Max. Negotiated Rate |
$8,170.16 |
| Rate for Payer: Aetna Commercial |
$7,716.27
|
| Rate for Payer: Aetna Medicare |
$2,360.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,836.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,836.86
|
| Rate for Payer: BCBS Complete |
$1,680.33
|
| Rate for Payer: BCBS MAPPO |
$2,269.49
|
| Rate for Payer: BCBS Trust/PPO |
$7,462.99
|
| Rate for Payer: BCN Commercial |
$7,462.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,269.49
|
| Rate for Payer: Cash Price |
$7,262.37
|
| Rate for Payer: Cofinity Commercial |
$7,807.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,269.49
|
| Rate for Payer: Healthscope Commercial |
$8,170.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,808.47
|
| Rate for Payer: Mclaren Medicaid |
$1,600.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,382.96
|
| Rate for Payer: Meridian Medicaid |
$1,680.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,609.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,496.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.27
|
| Rate for Payer: Nomi Health Commercial |
$7,443.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,808.47
|
| Rate for Payer: PACE Senior Care Partners |
$2,156.02
|
| Rate for Payer: PACE SWMI |
$2,269.49
|
| Rate for Payer: PHP Commercial |
$7,716.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,269.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,600.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,897.83
|
| Rate for Payer: Priority Health Medicare |
$2,292.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,318.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,269.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,988.60
|
| Rate for Payer: UHC Core |
$7,580.10
|
| Rate for Payer: UHC Exchange |
$2,269.49
|
| Rate for Payer: UHC Medicaid |
$1,600.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,269.49
|
| Rate for Payer: UHCCP Medicaid |
$1,600.44
|
| Rate for Payer: VA VA |
$2,269.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,808.47
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$9,077.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,318.26 |
| Max. Negotiated Rate |
$8,170.16 |
| Rate for Payer: Aetna Commercial |
$7,716.27
|
| Rate for Payer: BCBS Trust/PPO |
$7,497.49
|
| Rate for Payer: BCN Commercial |
$7,497.49
|
| Rate for Payer: Cash Price |
$7,262.37
|
| Rate for Payer: Cofinity Commercial |
$7,807.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.37
|
| Rate for Payer: Healthscope Commercial |
$8,170.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,808.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.27
|
| Rate for Payer: Nomi Health Commercial |
$7,443.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,808.47
|
| Rate for Payer: PHP Commercial |
$7,716.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,897.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,318.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,988.60
|
| Rate for Payer: UHC Core |
$7,580.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,808.47
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Medicare |
$7.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.45
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$6.76
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCN Commercial |
$22.24
|
| Rate for Payer: BCN Medicare Advantage |
$6.76
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.76
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.10
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.42
|
| Rate for Payer: PACE SWMI |
$6.76
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Medicare Advantage |
$6.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Medicare |
$6.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: Railroad Medicare Medicare |
$6.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: UHC Exchange |
$6.76
|
| Rate for Payer: UHC Medicaid |
$4.77
|
| Rate for Payer: UHC Medicare Advantage |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$4.77
|
| Rate for Payer: VA VA |
$6.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: BCBS Trust/PPO |
$22.34
|
| Rate for Payer: BCN Commercial |
$22.34
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.29
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$353.99 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: BCBS Trust/PPO |
$420.06
|
| Rate for Payer: BCN Commercial |
$420.06
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.58
|
| Rate for Payer: UHC Core |
$424.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$132.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.94
|
| Rate for Payer: BCBS Complete |
$94.14
|
| Rate for Payer: BCBS MAPPO |
$127.15
|
| Rate for Payer: BCBS Trust/PPO |
$418.13
|
| Rate for Payer: BCN Commercial |
$418.13
|
| Rate for Payer: BCN Medicare Advantage |
$127.15
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.15
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.51
|
| Rate for Payer: Meridian Medicaid |
$94.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Senior Care Partners |
$120.79
|
| Rate for Payer: PACE SWMI |
$127.15
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$127.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.49
|
| Rate for Payer: Priority Health Medicare |
$128.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.99
|
| Rate for Payer: Railroad Medicare Medicare |
$127.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.58
|
| Rate for Payer: UHC Core |
$424.69
|
| Rate for Payer: UHC Exchange |
$127.15
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHC Medicare Advantage |
$127.15
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
| Rate for Payer: VA VA |
$127.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$407.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.90 |
| Max. Negotiated Rate |
$367.05 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$106.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.45
|
| Rate for Payer: BCBS Complete |
$75.49
|
| Rate for Payer: BCBS MAPPO |
$101.96
|
| Rate for Payer: BCBS Trust/PPO |
$335.28
|
| Rate for Payer: BCN Commercial |
$335.28
|
| Rate for Payer: BCN Medicare Advantage |
$101.96
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cofinity Commercial |
$350.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.96
|
| Rate for Payer: Healthscope Commercial |
$367.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.87
|
| Rate for Payer: Mclaren Medicaid |
$71.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.06
|
| Rate for Payer: Meridian Medicaid |
$75.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$334.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.87
|
| Rate for Payer: PACE Senior Care Partners |
$96.86
|
| Rate for Payer: PACE SWMI |
$101.96
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: PHP Medicare Advantage |
$101.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$354.81
|
| Rate for Payer: Priority Health Medicare |
$102.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.85
|
| Rate for Payer: Railroad Medicare Medicare |
$101.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.89
|
| Rate for Payer: UHC Core |
$340.54
|
| Rate for Payer: UHC Exchange |
$101.96
|
| Rate for Payer: UHC Medicaid |
$71.90
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
| Rate for Payer: UHCCP Medicaid |
$71.90
|
| Rate for Payer: VA VA |
$101.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.87
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$407.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$283.85 |
| Max. Negotiated Rate |
$367.05 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: BCBS Trust/PPO |
$336.83
|
| Rate for Payer: BCN Commercial |
$336.83
|
| Rate for Payer: Cash Price |
$326.26
|
| Rate for Payer: Cofinity Commercial |
$350.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.26
|
| Rate for Payer: Healthscope Commercial |
$367.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$334.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$305.87
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$354.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.89
|
| Rate for Payer: UHC Core |
$340.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.87
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
OP
|
$1,825.18
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.78 |
| Max. Negotiated Rate |
$1,642.66 |
| Rate for Payer: Aetna Commercial |
$1,551.40
|
| Rate for Payer: Aetna Medicare |
$474.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$570.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$570.37
|
| Rate for Payer: BCBS Complete |
$337.84
|
| Rate for Payer: BCBS MAPPO |
$456.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.48
|
| Rate for Payer: BCN Commercial |
$1,500.48
|
| Rate for Payer: BCN Medicare Advantage |
$456.30
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cofinity Commercial |
$1,569.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.30
|
| Rate for Payer: Healthscope Commercial |
$1,642.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,368.88
|
| Rate for Payer: Mclaren Medicaid |
$321.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.11
|
| Rate for Payer: Meridian Medicaid |
$337.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$524.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$501.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,551.40
|
| Rate for Payer: Nomi Health Commercial |
$1,496.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.88
|
| Rate for Payer: PACE Senior Care Partners |
$433.48
|
| Rate for Payer: PACE SWMI |
$456.30
|
| Rate for Payer: PHP Commercial |
$1,551.40
|
| Rate for Payer: PHP Medicare Advantage |
$456.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,587.91
|
| Rate for Payer: Priority Health Medicare |
$460.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,270.33
|
| Rate for Payer: Railroad Medicare Medicare |
$456.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.16
|
| Rate for Payer: UHC Core |
$1,524.03
|
| Rate for Payer: UHC Exchange |
$456.30
|
| Rate for Payer: UHC Medicaid |
$321.78
|
| Rate for Payer: UHC Medicare Advantage |
$456.30
|
| Rate for Payer: UHCCP Medicaid |
$321.78
|
| Rate for Payer: VA VA |
$456.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,368.88
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
IP
|
$1,825.18
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,270.33 |
| Max. Negotiated Rate |
$1,642.66 |
| Rate for Payer: Aetna Commercial |
$1,551.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,507.42
|
| Rate for Payer: BCN Commercial |
$1,507.42
|
| Rate for Payer: Cash Price |
$1,460.14
|
| Rate for Payer: Cofinity Commercial |
$1,569.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.14
|
| Rate for Payer: Healthscope Commercial |
$1,642.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,368.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,551.40
|
| Rate for Payer: Nomi Health Commercial |
$1,496.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.88
|
| Rate for Payer: PHP Commercial |
$1,551.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,587.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,270.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.16
|
| Rate for Payer: UHC Core |
$1,524.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,368.88
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
OP
|
$199.90
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$179.91 |
| Rate for Payer: Aetna Commercial |
$169.91
|
| Rate for Payer: Aetna Medicare |
$51.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.47
|
| Rate for Payer: BCBS Complete |
$37.00
|
| Rate for Payer: BCBS MAPPO |
$49.98
|
| Rate for Payer: BCBS Trust/PPO |
$164.34
|
| Rate for Payer: BCN Commercial |
$164.34
|
| Rate for Payer: BCN Medicare Advantage |
$49.98
|
| Rate for Payer: Cash Price |
$159.92
|
| Rate for Payer: Cofinity Commercial |
$171.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.98
|
| Rate for Payer: Healthscope Commercial |
$179.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.93
|
| Rate for Payer: Mclaren Medicaid |
$35.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.47
|
| Rate for Payer: Meridian Medicaid |
$37.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.91
|
| Rate for Payer: Nomi Health Commercial |
$163.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.93
|
| Rate for Payer: PACE Senior Care Partners |
$47.48
|
| Rate for Payer: PACE SWMI |
$49.98
|
| Rate for Payer: PHP Commercial |
$169.91
|
| Rate for Payer: PHP Medicare Advantage |
$49.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.91
|
| Rate for Payer: Priority Health Medicare |
$50.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.13
|
| Rate for Payer: Railroad Medicare Medicare |
$49.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.91
|
| Rate for Payer: UHC Core |
$166.92
|
| Rate for Payer: UHC Exchange |
$49.98
|
| Rate for Payer: UHC Medicaid |
$35.24
|
| Rate for Payer: UHC Medicare Advantage |
$49.98
|
| Rate for Payer: UHCCP Medicaid |
$35.24
|
| Rate for Payer: VA VA |
$49.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.93
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
IP
|
$199.90
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$139.13 |
| Max. Negotiated Rate |
$179.91 |
| Rate for Payer: Aetna Commercial |
$169.91
|
| Rate for Payer: BCBS Trust/PPO |
$165.10
|
| Rate for Payer: BCN Commercial |
$165.10
|
| Rate for Payer: Cash Price |
$159.92
|
| Rate for Payer: Cofinity Commercial |
$171.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.92
|
| Rate for Payer: Healthscope Commercial |
$179.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.91
|
| Rate for Payer: Nomi Health Commercial |
$163.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.93
|
| Rate for Payer: PHP Commercial |
$169.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.91
|
| Rate for Payer: UHC Core |
$166.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.93
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
OP
|
$96.18
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.96 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Aetna Commercial |
$81.75
|
| Rate for Payer: Aetna Medicare |
$25.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.06
|
| Rate for Payer: BCBS Complete |
$17.80
|
| Rate for Payer: BCBS MAPPO |
$24.05
|
| Rate for Payer: BCBS Trust/PPO |
$79.07
|
| Rate for Payer: BCN Commercial |
$79.07
|
| Rate for Payer: BCN Medicare Advantage |
$24.05
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cofinity Commercial |
$82.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.05
|
| Rate for Payer: Healthscope Commercial |
$86.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.14
|
| Rate for Payer: Mclaren Medicaid |
$16.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.25
|
| Rate for Payer: Meridian Medicaid |
$17.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.75
|
| Rate for Payer: Nomi Health Commercial |
$78.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.14
|
| Rate for Payer: PACE Senior Care Partners |
$22.84
|
| Rate for Payer: PACE SWMI |
$24.05
|
| Rate for Payer: PHP Commercial |
$81.75
|
| Rate for Payer: PHP Medicare Advantage |
$24.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.68
|
| Rate for Payer: Priority Health Medicare |
$24.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: Railroad Medicare Medicare |
$24.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.64
|
| Rate for Payer: UHC Core |
$80.31
|
| Rate for Payer: UHC Exchange |
$24.05
|
| Rate for Payer: UHC Medicaid |
$16.96
|
| Rate for Payer: UHC Medicare Advantage |
$24.05
|
| Rate for Payer: UHCCP Medicaid |
$16.96
|
| Rate for Payer: VA VA |
$24.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.14
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
IP
|
$96.18
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.94 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Aetna Commercial |
$81.75
|
| Rate for Payer: BCBS Trust/PPO |
$79.44
|
| Rate for Payer: BCN Commercial |
$79.44
|
| Rate for Payer: Cash Price |
$76.94
|
| Rate for Payer: Cofinity Commercial |
$82.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.94
|
| Rate for Payer: Healthscope Commercial |
$86.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.75
|
| Rate for Payer: Nomi Health Commercial |
$78.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.14
|
| Rate for Payer: PHP Commercial |
$81.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.64
|
| Rate for Payer: UHC Core |
$80.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.14
|
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
OP
|
$355.31
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000072
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$319.78 |
| Rate for Payer: Aetna Commercial |
$302.01
|
| Rate for Payer: Aetna Medicare |
$92.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.03
|
| Rate for Payer: BCBS Complete |
$65.77
|
| Rate for Payer: BCBS MAPPO |
$88.83
|
| Rate for Payer: BCBS Trust/PPO |
$292.10
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$292.10
|
| Rate for Payer: BCN Medicare Advantage |
$88.83
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cofinity Commercial |
$305.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.83
|
| Rate for Payer: Healthscope Commercial |
$319.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.48
|
| Rate for Payer: Mclaren Medicaid |
$62.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.27
|
| Rate for Payer: Meridian Medicaid |
$65.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.01
|
| Rate for Payer: Nomi Health Commercial |
$291.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.48
|
| Rate for Payer: PACE Senior Care Partners |
$84.39
|
| Rate for Payer: PACE SWMI |
$88.83
|
| Rate for Payer: PHP Commercial |
$302.01
|
| Rate for Payer: PHP Medicare Advantage |
$88.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$309.12
|
| Rate for Payer: Priority Health Medicare |
$89.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.30
|
| Rate for Payer: Railroad Medicare Medicare |
$88.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.67
|
| Rate for Payer: UHC Core |
$296.68
|
| Rate for Payer: UHC Exchange |
$88.83
|
| Rate for Payer: UHC Medicaid |
$62.64
|
| Rate for Payer: UHC Medicare Advantage |
$88.83
|
| Rate for Payer: UHCCP Medicaid |
$62.64
|
| Rate for Payer: VA VA |
$88.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.48
|
|
