|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$238.35
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$214.51 |
| Rate for Payer: Aetna Commercial |
$202.60
|
| Rate for Payer: BCBS Trust/PPO |
$196.85
|
| Rate for Payer: BCN Commercial |
$196.85
|
| Rate for Payer: Cash Price |
$190.68
|
| Rate for Payer: Cofinity Commercial |
$204.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.68
|
| Rate for Payer: Healthscope Commercial |
$214.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.60
|
| Rate for Payer: Nomi Health Commercial |
$195.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.76
|
| Rate for Payer: PHP Commercial |
$202.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.75
|
| Rate for Payer: UHC Core |
$199.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.76
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$238.35
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.02 |
| Max. Negotiated Rate |
$214.51 |
| Rate for Payer: Aetna Commercial |
$202.60
|
| Rate for Payer: Aetna Medicare |
$61.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.48
|
| Rate for Payer: BCBS Complete |
$44.12
|
| Rate for Payer: BCBS MAPPO |
$59.59
|
| Rate for Payer: BCBS Trust/PPO |
$195.95
|
| Rate for Payer: BCN Commercial |
$195.95
|
| Rate for Payer: BCN Medicare Advantage |
$59.59
|
| Rate for Payer: Cash Price |
$190.68
|
| Rate for Payer: Cofinity Commercial |
$204.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.59
|
| Rate for Payer: Healthscope Commercial |
$214.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.76
|
| Rate for Payer: Mclaren Medicaid |
$42.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.57
|
| Rate for Payer: Meridian Medicaid |
$44.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.60
|
| Rate for Payer: Nomi Health Commercial |
$195.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.76
|
| Rate for Payer: PACE Senior Care Partners |
$56.61
|
| Rate for Payer: PACE SWMI |
$59.59
|
| Rate for Payer: PHP Commercial |
$202.60
|
| Rate for Payer: PHP Medicare Advantage |
$59.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.36
|
| Rate for Payer: Priority Health Medicare |
$60.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.89
|
| Rate for Payer: Railroad Medicare Medicare |
$59.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.75
|
| Rate for Payer: UHC Core |
$199.02
|
| Rate for Payer: UHC Exchange |
$59.59
|
| Rate for Payer: UHC Medicaid |
$42.02
|
| Rate for Payer: UHC Medicare Advantage |
$59.59
|
| Rate for Payer: UHCCP Medicaid |
$42.02
|
| Rate for Payer: VA VA |
$59.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.76
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,637.46
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$288.68 |
| Max. Negotiated Rate |
$1,473.71 |
| Rate for Payer: Aetna Commercial |
$1,391.84
|
| Rate for Payer: Aetna Medicare |
$425.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$511.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$511.71
|
| Rate for Payer: BCBS Complete |
$303.09
|
| Rate for Payer: BCBS MAPPO |
$409.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,346.16
|
| Rate for Payer: BCN Commercial |
$1,346.16
|
| Rate for Payer: BCN Medicare Advantage |
$409.37
|
| Rate for Payer: Cash Price |
$1,309.97
|
| Rate for Payer: Cofinity Commercial |
$1,408.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,309.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.37
|
| Rate for Payer: Healthscope Commercial |
$1,473.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,228.10
|
| Rate for Payer: Mclaren Medicaid |
$288.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.83
|
| Rate for Payer: Meridian Medicaid |
$303.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$470.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,391.84
|
| Rate for Payer: Nomi Health Commercial |
$1,342.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,228.10
|
| Rate for Payer: PACE Senior Care Partners |
$388.90
|
| Rate for Payer: PACE SWMI |
$409.37
|
| Rate for Payer: PHP Commercial |
$1,391.84
|
| Rate for Payer: PHP Medicare Advantage |
$409.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,424.59
|
| Rate for Payer: Priority Health Medicare |
$413.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,139.67
|
| Rate for Payer: Railroad Medicare Medicare |
$409.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,440.96
|
| Rate for Payer: UHC Core |
$1,367.28
|
| Rate for Payer: UHC Exchange |
$409.37
|
| Rate for Payer: UHC Medicaid |
$288.68
|
| Rate for Payer: UHC Medicare Advantage |
$409.37
|
| Rate for Payer: UHCCP Medicaid |
$288.68
|
| Rate for Payer: VA VA |
$409.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,228.10
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,637.46
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$1,139.67 |
| Max. Negotiated Rate |
$1,473.71 |
| Rate for Payer: Aetna Commercial |
$1,391.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.38
|
| Rate for Payer: BCN Commercial |
$1,352.38
|
| Rate for Payer: Cash Price |
$1,309.97
|
| Rate for Payer: Cofinity Commercial |
$1,408.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,309.97
|
| Rate for Payer: Healthscope Commercial |
$1,473.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,228.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,391.84
|
| Rate for Payer: Nomi Health Commercial |
$1,342.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,228.10
|
| Rate for Payer: PHP Commercial |
$1,391.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,424.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,139.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,440.96
|
| Rate for Payer: UHC Core |
$1,367.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,228.10
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
OP
|
$15,187.37
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,677.53 |
| Max. Negotiated Rate |
$13,668.63 |
| Rate for Payer: Aetna Commercial |
$12,909.26
|
| Rate for Payer: Aetna Medicare |
$3,948.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,746.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,746.05
|
| Rate for Payer: BCBS Complete |
$2,811.18
|
| Rate for Payer: BCBS MAPPO |
$3,796.84
|
| Rate for Payer: BCBS Trust/PPO |
$12,485.54
|
| Rate for Payer: BCN Commercial |
$12,485.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,796.84
|
| Rate for Payer: Cash Price |
$12,149.90
|
| Rate for Payer: Cofinity Commercial |
$13,061.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,149.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,796.84
|
| Rate for Payer: Healthscope Commercial |
$13,668.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,390.53
|
| Rate for Payer: Mclaren Medicaid |
$2,677.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,986.68
|
| Rate for Payer: Meridian Medicaid |
$2,811.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,366.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,176.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,909.26
|
| Rate for Payer: Nomi Health Commercial |
$12,453.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,390.53
|
| Rate for Payer: PACE Senior Care Partners |
$3,607.00
|
| Rate for Payer: PACE SWMI |
$3,796.84
|
| Rate for Payer: PHP Commercial |
$12,909.26
|
| Rate for Payer: PHP Medicare Advantage |
$3,796.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,677.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,213.01
|
| Rate for Payer: Priority Health Medicare |
$3,834.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,570.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,796.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,364.89
|
| Rate for Payer: UHC Core |
$12,681.45
|
| Rate for Payer: UHC Exchange |
$3,796.84
|
| Rate for Payer: UHC Medicaid |
$2,677.53
|
| Rate for Payer: UHC Medicare Advantage |
$3,796.84
|
| Rate for Payer: UHCCP Medicaid |
$2,677.53
|
| Rate for Payer: VA VA |
$3,796.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,390.53
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$15,187.37
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,570.41 |
| Max. Negotiated Rate |
$13,668.63 |
| Rate for Payer: Aetna Commercial |
$12,909.26
|
| Rate for Payer: BCBS Trust/PPO |
$12,543.25
|
| Rate for Payer: BCN Commercial |
$12,543.25
|
| Rate for Payer: Cash Price |
$12,149.90
|
| Rate for Payer: Cofinity Commercial |
$13,061.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,149.90
|
| Rate for Payer: Healthscope Commercial |
$13,668.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,390.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,909.26
|
| Rate for Payer: Nomi Health Commercial |
$12,453.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,390.53
|
| Rate for Payer: PHP Commercial |
$12,909.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,213.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,570.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,364.89
|
| Rate for Payer: UHC Core |
$12,681.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,390.53
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
IP
|
$15,187.37
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,570.41 |
| Max. Negotiated Rate |
$13,668.63 |
| Rate for Payer: Aetna Commercial |
$12,909.26
|
| Rate for Payer: BCBS Trust/PPO |
$12,543.25
|
| Rate for Payer: BCN Commercial |
$12,543.25
|
| Rate for Payer: Cash Price |
$12,149.90
|
| Rate for Payer: Cofinity Commercial |
$13,061.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,149.90
|
| Rate for Payer: Healthscope Commercial |
$13,668.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,390.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,909.26
|
| Rate for Payer: Nomi Health Commercial |
$12,453.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,390.53
|
| Rate for Payer: PHP Commercial |
$12,909.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,213.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,570.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,364.89
|
| Rate for Payer: UHC Core |
$12,681.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,390.53
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
OP
|
$15,187.37
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,677.53 |
| Max. Negotiated Rate |
$13,668.63 |
| Rate for Payer: Aetna Commercial |
$12,909.26
|
| Rate for Payer: Aetna Medicare |
$3,948.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,746.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,746.05
|
| Rate for Payer: BCBS Complete |
$2,811.18
|
| Rate for Payer: BCBS MAPPO |
$3,796.84
|
| Rate for Payer: BCBS Trust/PPO |
$12,485.54
|
| Rate for Payer: BCN Commercial |
$12,485.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,796.84
|
| Rate for Payer: Cash Price |
$12,149.90
|
| Rate for Payer: Cofinity Commercial |
$13,061.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,149.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,796.84
|
| Rate for Payer: Healthscope Commercial |
$13,668.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,390.53
|
| Rate for Payer: Mclaren Medicaid |
$2,677.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,986.68
|
| Rate for Payer: Meridian Medicaid |
$2,811.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,366.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,176.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,909.26
|
| Rate for Payer: Nomi Health Commercial |
$12,453.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,390.53
|
| Rate for Payer: PACE Senior Care Partners |
$3,607.00
|
| Rate for Payer: PACE SWMI |
$3,796.84
|
| Rate for Payer: PHP Commercial |
$12,909.26
|
| Rate for Payer: PHP Medicare Advantage |
$3,796.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,677.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,213.01
|
| Rate for Payer: Priority Health Medicare |
$3,834.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,570.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,796.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,364.89
|
| Rate for Payer: UHC Core |
$12,681.45
|
| Rate for Payer: UHC Exchange |
$3,796.84
|
| Rate for Payer: UHC Medicaid |
$2,677.53
|
| Rate for Payer: UHC Medicare Advantage |
$3,796.84
|
| Rate for Payer: UHCCP Medicaid |
$2,677.53
|
| Rate for Payer: VA VA |
$3,796.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,390.53
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
IP
|
$12,327.15
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,579.70 |
| Max. Negotiated Rate |
$11,094.43 |
| Rate for Payer: Aetna Commercial |
$10,478.08
|
| Rate for Payer: BCBS Trust/PPO |
$10,180.99
|
| Rate for Payer: BCN Commercial |
$10,180.99
|
| Rate for Payer: Cash Price |
$9,861.72
|
| Rate for Payer: Cofinity Commercial |
$10,601.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,861.72
|
| Rate for Payer: Healthscope Commercial |
$11,094.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,245.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,478.08
|
| Rate for Payer: Nomi Health Commercial |
$10,108.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,245.36
|
| Rate for Payer: PHP Commercial |
$10,478.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,724.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,579.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,847.89
|
| Rate for Payer: UHC Core |
$10,293.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,245.36
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
OP
|
$12,327.15
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,173.28 |
| Max. Negotiated Rate |
$11,094.43 |
| Rate for Payer: Aetna Commercial |
$10,478.08
|
| Rate for Payer: Aetna Medicare |
$3,205.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,852.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,852.23
|
| Rate for Payer: BCBS Complete |
$2,281.76
|
| Rate for Payer: BCBS MAPPO |
$3,081.79
|
| Rate for Payer: BCBS Trust/PPO |
$10,134.15
|
| Rate for Payer: BCN Commercial |
$10,134.15
|
| Rate for Payer: BCN Medicare Advantage |
$3,081.79
|
| Rate for Payer: Cash Price |
$9,861.72
|
| Rate for Payer: Cofinity Commercial |
$10,601.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,861.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,081.79
|
| Rate for Payer: Healthscope Commercial |
$11,094.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,245.36
|
| Rate for Payer: Mclaren Medicaid |
$2,173.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,235.88
|
| Rate for Payer: Meridian Medicaid |
$2,281.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,544.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,389.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,478.08
|
| Rate for Payer: Nomi Health Commercial |
$10,108.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,245.36
|
| Rate for Payer: PACE Senior Care Partners |
$2,927.70
|
| Rate for Payer: PACE SWMI |
$3,081.79
|
| Rate for Payer: PHP Commercial |
$10,478.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,081.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,173.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,724.62
|
| Rate for Payer: Priority Health Medicare |
$3,112.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,579.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,081.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,847.89
|
| Rate for Payer: UHC Core |
$10,293.17
|
| Rate for Payer: UHC Exchange |
$3,081.79
|
| Rate for Payer: UHC Medicaid |
$2,173.28
|
| Rate for Payer: UHC Medicare Advantage |
$3,081.79
|
| Rate for Payer: UHCCP Medicaid |
$2,173.28
|
| Rate for Payer: VA VA |
$3,081.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,245.36
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
IP
|
$13,229.90
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,208.01 |
| Max. Negotiated Rate |
$11,906.91 |
| Rate for Payer: Aetna Commercial |
$11,245.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,926.57
|
| Rate for Payer: BCN Commercial |
$10,926.57
|
| Rate for Payer: Cash Price |
$10,583.92
|
| Rate for Payer: Cofinity Commercial |
$11,377.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,583.92
|
| Rate for Payer: Healthscope Commercial |
$11,906.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,922.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,245.42
|
| Rate for Payer: Nomi Health Commercial |
$10,848.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,922.42
|
| Rate for Payer: PHP Commercial |
$11,245.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,510.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,208.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,642.31
|
| Rate for Payer: UHC Core |
$11,046.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,922.42
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
OP
|
$13,229.90
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,332.43 |
| Max. Negotiated Rate |
$11,906.91 |
| Rate for Payer: Aetna Commercial |
$11,245.42
|
| Rate for Payer: Aetna Medicare |
$3,439.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,134.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,134.34
|
| Rate for Payer: BCBS Complete |
$2,448.85
|
| Rate for Payer: BCBS MAPPO |
$3,307.47
|
| Rate for Payer: BCBS Trust/PPO |
$10,876.30
|
| Rate for Payer: BCN Commercial |
$10,876.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,307.47
|
| Rate for Payer: Cash Price |
$10,583.92
|
| Rate for Payer: Cofinity Commercial |
$11,377.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,583.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,307.47
|
| Rate for Payer: Healthscope Commercial |
$11,906.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,922.42
|
| Rate for Payer: Mclaren Medicaid |
$2,332.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,472.85
|
| Rate for Payer: Meridian Medicaid |
$2,448.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,803.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,638.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,245.42
|
| Rate for Payer: Nomi Health Commercial |
$10,848.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,922.42
|
| Rate for Payer: PACE Senior Care Partners |
$3,142.10
|
| Rate for Payer: PACE SWMI |
$3,307.47
|
| Rate for Payer: PHP Commercial |
$11,245.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,307.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,332.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,510.01
|
| Rate for Payer: Priority Health Medicare |
$3,340.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,208.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3,307.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,642.31
|
| Rate for Payer: UHC Core |
$11,046.97
|
| Rate for Payer: UHC Exchange |
$3,307.47
|
| Rate for Payer: UHC Medicaid |
$2,332.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,307.47
|
| Rate for Payer: UHCCP Medicaid |
$2,332.43
|
| Rate for Payer: VA VA |
$3,307.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,922.42
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
OP
|
$13,229.90
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,332.43 |
| Max. Negotiated Rate |
$11,906.91 |
| Rate for Payer: Aetna Commercial |
$11,245.42
|
| Rate for Payer: Aetna Medicare |
$3,439.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,134.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,134.34
|
| Rate for Payer: BCBS Complete |
$2,448.85
|
| Rate for Payer: BCBS MAPPO |
$3,307.47
|
| Rate for Payer: BCBS Trust/PPO |
$10,876.30
|
| Rate for Payer: BCN Commercial |
$10,876.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,307.47
|
| Rate for Payer: Cash Price |
$10,583.92
|
| Rate for Payer: Cofinity Commercial |
$11,377.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,583.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,307.47
|
| Rate for Payer: Healthscope Commercial |
$11,906.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,922.42
|
| Rate for Payer: Mclaren Medicaid |
$2,332.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,472.85
|
| Rate for Payer: Meridian Medicaid |
$2,448.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,803.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,638.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,245.42
|
| Rate for Payer: Nomi Health Commercial |
$10,848.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,922.42
|
| Rate for Payer: PACE Senior Care Partners |
$3,142.10
|
| Rate for Payer: PACE SWMI |
$3,307.47
|
| Rate for Payer: PHP Commercial |
$11,245.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,307.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,332.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,510.01
|
| Rate for Payer: Priority Health Medicare |
$3,340.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,208.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3,307.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,642.31
|
| Rate for Payer: UHC Core |
$11,046.97
|
| Rate for Payer: UHC Exchange |
$3,307.47
|
| Rate for Payer: UHC Medicaid |
$2,332.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,307.47
|
| Rate for Payer: UHCCP Medicaid |
$2,332.43
|
| Rate for Payer: VA VA |
$3,307.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,922.42
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
IP
|
$13,229.90
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,208.01 |
| Max. Negotiated Rate |
$11,906.91 |
| Rate for Payer: Aetna Commercial |
$11,245.42
|
| Rate for Payer: BCBS Trust/PPO |
$10,926.57
|
| Rate for Payer: BCN Commercial |
$10,926.57
|
| Rate for Payer: Cash Price |
$10,583.92
|
| Rate for Payer: Cofinity Commercial |
$11,377.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,583.92
|
| Rate for Payer: Healthscope Commercial |
$11,906.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,922.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,245.42
|
| Rate for Payer: Nomi Health Commercial |
$10,848.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,922.42
|
| Rate for Payer: PHP Commercial |
$11,245.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,510.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,208.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,642.31
|
| Rate for Payer: UHC Core |
$11,046.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,922.42
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
IP
|
$2,295.46
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,597.64 |
| Max. Negotiated Rate |
$2,065.91 |
| Rate for Payer: Aetna Commercial |
$1,951.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.82
|
| Rate for Payer: BCN Commercial |
$1,895.82
|
| Rate for Payer: Cash Price |
$1,836.37
|
| Rate for Payer: Cofinity Commercial |
$1,974.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,836.37
|
| Rate for Payer: Healthscope Commercial |
$2,065.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,721.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,951.14
|
| Rate for Payer: Nomi Health Commercial |
$1,882.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,721.60
|
| Rate for Payer: PHP Commercial |
$1,951.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,997.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,597.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,020.00
|
| Rate for Payer: UHC Core |
$1,916.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,721.60
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
OP
|
$2,295.46
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$404.69 |
| Max. Negotiated Rate |
$2,065.91 |
| Rate for Payer: Aetna Commercial |
$1,951.14
|
| Rate for Payer: Aetna Medicare |
$596.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$717.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$717.33
|
| Rate for Payer: BCBS Complete |
$424.89
|
| Rate for Payer: BCBS MAPPO |
$573.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,887.10
|
| Rate for Payer: BCN Commercial |
$1,887.10
|
| Rate for Payer: BCN Medicare Advantage |
$573.87
|
| Rate for Payer: Cash Price |
$1,836.37
|
| Rate for Payer: Cofinity Commercial |
$1,974.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,836.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.87
|
| Rate for Payer: Healthscope Commercial |
$2,065.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,721.60
|
| Rate for Payer: Mclaren Medicaid |
$404.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.56
|
| Rate for Payer: Meridian Medicaid |
$424.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$659.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$631.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,951.14
|
| Rate for Payer: Nomi Health Commercial |
$1,882.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,721.60
|
| Rate for Payer: PACE Senior Care Partners |
$545.17
|
| Rate for Payer: PACE SWMI |
$573.87
|
| Rate for Payer: PHP Commercial |
$1,951.14
|
| Rate for Payer: PHP Medicare Advantage |
$573.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,997.05
|
| Rate for Payer: Priority Health Medicare |
$579.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,597.64
|
| Rate for Payer: Railroad Medicare Medicare |
$573.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,020.00
|
| Rate for Payer: UHC Core |
$1,916.71
|
| Rate for Payer: UHC Exchange |
$573.87
|
| Rate for Payer: UHC Medicaid |
$404.69
|
| Rate for Payer: UHC Medicare Advantage |
$573.87
|
| Rate for Payer: UHCCP Medicaid |
$404.69
|
| Rate for Payer: VA VA |
$573.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,721.60
|
|
|
HC ATS STAND BY HR
|
Facility
|
IP
|
$1,567.87
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,091.24 |
| Max. Negotiated Rate |
$1,411.08 |
| Rate for Payer: Aetna Commercial |
$1,332.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,294.90
|
| Rate for Payer: BCN Commercial |
$1,294.90
|
| Rate for Payer: Cash Price |
$1,254.30
|
| Rate for Payer: Cofinity Commercial |
$1,348.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.30
|
| Rate for Payer: Healthscope Commercial |
$1,411.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.69
|
| Rate for Payer: Nomi Health Commercial |
$1,285.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,175.90
|
| Rate for Payer: PHP Commercial |
$1,332.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,364.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,091.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.73
|
| Rate for Payer: UHC Core |
$1,309.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.90
|
|
|
HC ATS STAND BY HR
|
Facility
|
OP
|
$1,567.87
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$276.42 |
| Max. Negotiated Rate |
$1,411.08 |
| Rate for Payer: Aetna Commercial |
$1,332.69
|
| Rate for Payer: Aetna Medicare |
$407.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.96
|
| Rate for Payer: BCBS Complete |
$290.21
|
| Rate for Payer: BCBS MAPPO |
$391.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.95
|
| Rate for Payer: BCN Commercial |
$1,288.95
|
| Rate for Payer: BCN Medicare Advantage |
$391.97
|
| Rate for Payer: Cash Price |
$1,254.30
|
| Rate for Payer: Cofinity Commercial |
$1,348.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.97
|
| Rate for Payer: Healthscope Commercial |
$1,411.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.90
|
| Rate for Payer: Mclaren Medicaid |
$276.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.57
|
| Rate for Payer: Meridian Medicaid |
$290.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$431.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.69
|
| Rate for Payer: Nomi Health Commercial |
$1,285.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,175.90
|
| Rate for Payer: PACE Senior Care Partners |
$372.37
|
| Rate for Payer: PACE SWMI |
$391.97
|
| Rate for Payer: PHP Commercial |
$1,332.69
|
| Rate for Payer: PHP Medicare Advantage |
$391.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,364.05
|
| Rate for Payer: Priority Health Medicare |
$395.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,091.24
|
| Rate for Payer: Railroad Medicare Medicare |
$391.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.73
|
| Rate for Payer: UHC Core |
$1,309.17
|
| Rate for Payer: UHC Exchange |
$391.97
|
| Rate for Payer: UHC Medicaid |
$276.42
|
| Rate for Payer: UHC Medicare Advantage |
$391.97
|
| Rate for Payer: UHCCP Medicaid |
$276.42
|
| Rate for Payer: VA VA |
$391.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.90
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM IGM
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
IP
|
$22.29
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: PHP Commercial |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.62
|
| Rate for Payer: UHC Core |
$18.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.72
|
|
|
HC ATYPICAL PNEUMO EVAL L PNEUM
|
Facility
|
OP
|
$22.29
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: BCBS Complete |
$4.13
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCN Commercial |
$18.32
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.72
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$18.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.39
|
| Rate for Payer: Priority Health Medicare |
$5.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.62
|
| Rate for Payer: UHC Core |
$18.61
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicaid |
$3.93
|
| Rate for Payer: UHC Medicare Advantage |
$5.57
|
| Rate for Payer: UHCCP Medicaid |
$3.93
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.72
|
|
|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
