|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,607.43
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,200.17 |
| Max. Negotiated Rate |
$3,246.69 |
| Rate for Payer: Aetna Commercial |
$3,066.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,787.82
|
| Rate for Payer: BCN Commercial |
$2,787.82
|
| Rate for Payer: Cash Price |
$2,885.94
|
| Rate for Payer: Cofinity Commercial |
$3,102.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.94
|
| Rate for Payer: Healthscope Commercial |
$3,246.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,066.32
|
| Rate for Payer: PHP Commercial |
$3,066.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,138.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,200.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,174.54
|
| Rate for Payer: UHC Core |
$3,012.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.57
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,607.43
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$856.76 |
| Max. Negotiated Rate |
$3,246.69 |
| Rate for Payer: Aetna Commercial |
$3,066.32
|
| Rate for Payer: Aetna Medicare |
$937.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,127.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,127.32
|
| Rate for Payer: BCBS Complete |
$1,442.97
|
| Rate for Payer: BCBS MAPPO |
$901.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,804.78
|
| Rate for Payer: BCN Commercial |
$2,804.78
|
| Rate for Payer: BCN Medicare Advantage |
$901.86
|
| Rate for Payer: Cash Price |
$2,885.94
|
| Rate for Payer: Cofinity Commercial |
$3,102.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.86
|
| Rate for Payer: Healthscope Commercial |
$3,246.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$946.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,037.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,066.32
|
| Rate for Payer: PACE Senior Care Partners |
$856.76
|
| Rate for Payer: PACE SWMI |
$901.86
|
| Rate for Payer: PHP Commercial |
$3,066.32
|
| Rate for Payer: PHP Medicare Advantage |
$901.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,525.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,138.46
|
| Rate for Payer: Priority Health Medicare |
$901.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,200.17
|
| Rate for Payer: Railroad Medicare Medicare |
$901.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,174.54
|
| Rate for Payer: UHC Core |
$3,012.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.86
|
| Rate for Payer: UHC Medicare Advantage |
$928.91
|
| Rate for Payer: VA VA |
$901.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.57
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$16.55
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$8.97
|
| Rate for Payer: BCBS MAPPO |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$5.36
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Mclaren Medicaid |
$8.54
|
| Rate for Payer: Meridian Medicaid |
$8.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Senior Care Partners |
$5.09
|
| Rate for Payer: PACE SWMI |
$5.36
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.36
|
| Rate for Payer: UHC Medicare Advantage |
$5.52
|
| Rate for Payer: VA VA |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,165.38
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$6,090.57
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,537.41
|
| Rate for Payer: BCN Commercial |
$5,537.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$5,732.30
|
| Rate for Payer: Cash Price |
$5,732.30
|
| Rate for Payer: Cash Price |
$5,732.30
|
| Rate for Payer: Cofinity Commercial |
$6,162.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,732.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$6,448.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,374.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,090.57
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$6,090.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,015.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,233.88
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,370.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,305.53
|
| Rate for Payer: UHC Core |
$5,983.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,374.04
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,636.90
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$3,273.21 |
| Rate for Payer: Aetna Commercial |
$3,091.36
|
| Rate for Payer: Aetna Medicare |
$945.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,136.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,136.53
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$909.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.69
|
| Rate for Payer: BCN Commercial |
$2,827.69
|
| Rate for Payer: BCN Medicare Advantage |
$909.22
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cofinity Commercial |
$3,127.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,909.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.22
|
| Rate for Payer: Healthscope Commercial |
$3,273.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,727.68
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$954.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,045.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,091.36
|
| Rate for Payer: PACE Senior Care Partners |
$863.76
|
| Rate for Payer: PACE SWMI |
$909.22
|
| Rate for Payer: PHP Commercial |
$3,091.36
|
| Rate for Payer: PHP Medicare Advantage |
$909.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,164.10
|
| Rate for Payer: Priority Health Medicare |
$909.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,218.15
|
| Rate for Payer: Railroad Medicare Medicare |
$909.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,200.47
|
| Rate for Payer: UHC Core |
$3,036.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$909.22
|
| Rate for Payer: UHC Medicare Advantage |
$936.50
|
| Rate for Payer: VA VA |
$909.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,727.68
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,636.90
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,218.15 |
| Max. Negotiated Rate |
$3,273.21 |
| Rate for Payer: Aetna Commercial |
$3,091.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,810.60
|
| Rate for Payer: BCN Commercial |
$2,810.60
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cofinity Commercial |
$3,127.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,909.52
|
| Rate for Payer: Healthscope Commercial |
$3,273.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,727.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,091.36
|
| Rate for Payer: PHP Commercial |
$3,091.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,164.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,218.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,200.47
|
| Rate for Payer: UHC Core |
$3,036.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,727.68
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,453.20
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,496.21 |
| Max. Negotiated Rate |
$2,207.88 |
| Rate for Payer: Aetna Commercial |
$2,085.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.83
|
| Rate for Payer: BCN Commercial |
$1,895.83
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cofinity Commercial |
$2,109.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.56
|
| Rate for Payer: Healthscope Commercial |
$2,207.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,839.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.22
|
| Rate for Payer: PHP Commercial |
$2,085.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,134.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,496.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,158.82
|
| Rate for Payer: UHC Core |
$2,048.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,839.90
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,453.20
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,207.88 |
| Rate for Payer: Aetna Commercial |
$2,085.22
|
| Rate for Payer: Aetna Medicare |
$637.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$766.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$766.62
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$613.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,907.36
|
| Rate for Payer: BCN Commercial |
$1,907.36
|
| Rate for Payer: BCN Medicare Advantage |
$613.30
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cofinity Commercial |
$2,109.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.30
|
| Rate for Payer: Healthscope Commercial |
$2,207.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,839.90
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$643.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$705.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.22
|
| Rate for Payer: PACE Senior Care Partners |
$582.64
|
| Rate for Payer: PACE SWMI |
$613.30
|
| Rate for Payer: PHP Commercial |
$2,085.22
|
| Rate for Payer: PHP Medicare Advantage |
$613.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,134.28
|
| Rate for Payer: Priority Health Medicare |
$613.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,496.21
|
| Rate for Payer: Railroad Medicare Medicare |
$613.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,158.82
|
| Rate for Payer: UHC Core |
$2,048.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.30
|
| Rate for Payer: UHC Medicare Advantage |
$631.70
|
| Rate for Payer: VA VA |
$613.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,839.90
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,346.70
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$3,912.03 |
| Rate for Payer: Aetna Commercial |
$3,694.70
|
| Rate for Payer: Aetna Medicare |
$1,130.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,358.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,358.34
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$1,086.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.56
|
| Rate for Payer: BCN Commercial |
$3,379.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.68
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cofinity Commercial |
$3,738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.68
|
| Rate for Payer: Healthscope Commercial |
$3,912.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.02
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,141.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,249.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,694.70
|
| Rate for Payer: PACE Senior Care Partners |
$1,032.34
|
| Rate for Payer: PACE SWMI |
$1,086.68
|
| Rate for Payer: PHP Commercial |
$3,694.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,042.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,781.63
|
| Rate for Payer: Priority Health Medicare |
$1,086.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,651.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,086.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,825.10
|
| Rate for Payer: UHC Core |
$3,629.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,086.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,119.28
|
| Rate for Payer: VA VA |
$1,086.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.02
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,346.70
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,651.05 |
| Max. Negotiated Rate |
$3,912.03 |
| Rate for Payer: Aetna Commercial |
$3,694.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,359.13
|
| Rate for Payer: BCN Commercial |
$3,359.13
|
| Rate for Payer: Cash Price |
$3,477.36
|
| Rate for Payer: Cofinity Commercial |
$3,738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.36
|
| Rate for Payer: Healthscope Commercial |
$3,912.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,694.70
|
| Rate for Payer: PHP Commercial |
$3,694.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,042.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,781.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,651.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,825.10
|
| Rate for Payer: UHC Core |
$3,629.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.02
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,075.90
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna Medicare |
$279.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$336.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$336.22
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$268.98
|
| Rate for Payer: BCBS Trust/PPO |
$836.51
|
| Rate for Payer: BCN Commercial |
$836.51
|
| Rate for Payer: BCN Medicare Advantage |
$268.98
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.98
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$282.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PACE Senior Care Partners |
$255.53
|
| Rate for Payer: PACE SWMI |
$268.98
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: PHP Medicare Advantage |
$268.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.03
|
| Rate for Payer: Priority Health Medicare |
$268.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: Railroad Medicare Medicare |
$268.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.79
|
| Rate for Payer: UHC Core |
$898.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.98
|
| Rate for Payer: UHC Medicare Advantage |
$277.04
|
| Rate for Payer: VA VA |
$268.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,075.90
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$656.19 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: BCBS Trust/PPO |
$831.46
|
| Rate for Payer: BCN Commercial |
$831.46
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.79
|
| Rate for Payer: UHC Core |
$898.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,921.32
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,729.19 |
| Rate for Payer: Aetna Commercial |
$1,633.12
|
| Rate for Payer: Aetna Medicare |
$499.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.41
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$480.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,493.83
|
| Rate for Payer: BCN Commercial |
$1,493.83
|
| Rate for Payer: BCN Medicare Advantage |
$480.33
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cofinity Commercial |
$1,652.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.33
|
| Rate for Payer: Healthscope Commercial |
$1,729.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.99
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.12
|
| Rate for Payer: PACE Senior Care Partners |
$456.31
|
| Rate for Payer: PACE SWMI |
$480.33
|
| Rate for Payer: PHP Commercial |
$1,633.12
|
| Rate for Payer: PHP Medicare Advantage |
$480.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.55
|
| Rate for Payer: Priority Health Medicare |
$480.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.81
|
| Rate for Payer: Railroad Medicare Medicare |
$480.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.76
|
| Rate for Payer: UHC Core |
$1,604.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$480.33
|
| Rate for Payer: UHC Medicare Advantage |
$494.74
|
| Rate for Payer: VA VA |
$480.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.99
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,921.32
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,171.81 |
| Max. Negotiated Rate |
$1,729.19 |
| Rate for Payer: Aetna Commercial |
$1,633.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.80
|
| Rate for Payer: BCN Commercial |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,537.06
|
| Rate for Payer: Cofinity Commercial |
$1,652.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.06
|
| Rate for Payer: Healthscope Commercial |
$1,729.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.12
|
| Rate for Payer: PHP Commercial |
$1,633.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.76
|
| Rate for Payer: UHC Core |
$1,604.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.99
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,575.39
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$960.83 |
| Max. Negotiated Rate |
$1,417.85 |
| Rate for Payer: Aetna Commercial |
$1,339.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.46
|
| Rate for Payer: BCN Commercial |
$1,217.46
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,260.31
|
| Rate for Payer: Healthscope Commercial |
$1,417.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,181.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,339.08
|
| Rate for Payer: PHP Commercial |
$1,339.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,370.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$960.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,386.34
|
| Rate for Payer: UHC Core |
$1,315.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,181.54
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,575.39
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$1,417.85 |
| Rate for Payer: Aetna Commercial |
$1,339.08
|
| Rate for Payer: Aetna Medicare |
$409.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.31
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$393.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,224.87
|
| Rate for Payer: BCN Commercial |
$1,224.87
|
| Rate for Payer: BCN Medicare Advantage |
$393.85
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cash Price |
$1,260.31
|
| Rate for Payer: Cofinity Commercial |
$1,354.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,260.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.85
|
| Rate for Payer: Healthscope Commercial |
$1,417.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,181.54
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,339.08
|
| Rate for Payer: PACE Senior Care Partners |
$374.16
|
| Rate for Payer: PACE SWMI |
$393.85
|
| Rate for Payer: PHP Commercial |
$1,339.08
|
| Rate for Payer: PHP Medicare Advantage |
$393.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,102.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,370.59
|
| Rate for Payer: Priority Health Medicare |
$393.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$960.83
|
| Rate for Payer: Railroad Medicare Medicare |
$393.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,386.34
|
| Rate for Payer: UHC Core |
$1,315.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.85
|
| Rate for Payer: UHC Medicare Advantage |
$405.66
|
| Rate for Payer: VA VA |
$393.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,181.54
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,405.52
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,467.13 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$2,044.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.99
|
| Rate for Payer: BCN Commercial |
$1,858.99
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cofinity Commercial |
$2,068.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,924.42
|
| Rate for Payer: Healthscope Commercial |
$2,164.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,804.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,044.69
|
| Rate for Payer: PHP Commercial |
$2,044.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,683.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,092.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,467.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,116.86
|
| Rate for Payer: UHC Core |
$2,008.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,804.14
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,405.52
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$2,164.97 |
| Rate for Payer: Aetna Commercial |
$2,044.69
|
| Rate for Payer: Aetna Medicare |
$625.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$751.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$751.72
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$601.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,870.29
|
| Rate for Payer: BCN Commercial |
$1,870.29
|
| Rate for Payer: BCN Medicare Advantage |
$601.38
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cash Price |
$1,924.42
|
| Rate for Payer: Cofinity Commercial |
$2,068.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,924.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$601.38
|
| Rate for Payer: Healthscope Commercial |
$2,164.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,804.14
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$631.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$691.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,044.69
|
| Rate for Payer: PACE Senior Care Partners |
$571.31
|
| Rate for Payer: PACE SWMI |
$601.38
|
| Rate for Payer: PHP Commercial |
$2,044.69
|
| Rate for Payer: PHP Medicare Advantage |
$601.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,683.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,092.80
|
| Rate for Payer: Priority Health Medicare |
$601.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,467.13
|
| Rate for Payer: Railroad Medicare Medicare |
$601.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,116.86
|
| Rate for Payer: UHC Core |
$2,008.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$601.38
|
| Rate for Payer: UHC Medicare Advantage |
$619.42
|
| Rate for Payer: VA VA |
$601.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,804.14
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
IP
|
$1,075.90
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$656.19 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: BCBS Trust/PPO |
$831.46
|
| Rate for Payer: BCN Commercial |
$831.46
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.79
|
| Rate for Payer: UHC Core |
$898.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
OP
|
$1,075.90
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$968.31 |
| Rate for Payer: Aetna Commercial |
$914.52
|
| Rate for Payer: Aetna Medicare |
$279.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$336.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$336.22
|
| Rate for Payer: BCBS Complete |
$430.36
|
| Rate for Payer: BCBS MAPPO |
$268.98
|
| Rate for Payer: BCBS Trust/PPO |
$836.51
|
| Rate for Payer: BCN Commercial |
$836.51
|
| Rate for Payer: BCN Medicare Advantage |
$268.98
|
| Rate for Payer: Cash Price |
$860.72
|
| Rate for Payer: Cofinity Commercial |
$925.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.98
|
| Rate for Payer: Healthscope Commercial |
$968.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$282.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.52
|
| Rate for Payer: PACE Senior Care Partners |
$255.53
|
| Rate for Payer: PACE SWMI |
$268.98
|
| Rate for Payer: PHP Commercial |
$914.52
|
| Rate for Payer: PHP Medicare Advantage |
$268.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.03
|
| Rate for Payer: Priority Health Medicare |
$268.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: Railroad Medicare Medicare |
$268.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.79
|
| Rate for Payer: UHC Core |
$898.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.98
|
| Rate for Payer: UHC Medicare Advantage |
$277.04
|
| Rate for Payer: VA VA |
$268.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.92
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
OP
|
$3,025.12
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,722.61 |
| Rate for Payer: Aetna Commercial |
$2,571.35
|
| Rate for Payer: Aetna Medicare |
$786.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$945.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$945.35
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$756.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,352.03
|
| Rate for Payer: BCN Commercial |
$2,352.03
|
| Rate for Payer: BCN Medicare Advantage |
$756.28
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cofinity Commercial |
$2,601.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,420.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$756.28
|
| Rate for Payer: Healthscope Commercial |
$2,722.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,268.84
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$794.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$869.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,571.35
|
| Rate for Payer: PACE Senior Care Partners |
$718.47
|
| Rate for Payer: PACE SWMI |
$756.28
|
| Rate for Payer: PHP Commercial |
$2,571.35
|
| Rate for Payer: PHP Medicare Advantage |
$756.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,117.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,631.85
|
| Rate for Payer: Priority Health Medicare |
$756.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,845.02
|
| Rate for Payer: Railroad Medicare Medicare |
$756.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,662.11
|
| Rate for Payer: UHC Core |
$2,525.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$756.28
|
| Rate for Payer: UHC Medicare Advantage |
$778.97
|
| Rate for Payer: VA VA |
$756.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,268.84
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
IP
|
$3,025.12
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,845.02 |
| Max. Negotiated Rate |
$2,722.61 |
| Rate for Payer: Aetna Commercial |
$2,571.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,337.81
|
| Rate for Payer: BCN Commercial |
$2,337.81
|
| Rate for Payer: Cash Price |
$2,420.10
|
| Rate for Payer: Cofinity Commercial |
$2,601.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,420.10
|
| Rate for Payer: Healthscope Commercial |
$2,722.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,268.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,571.35
|
| Rate for Payer: PHP Commercial |
$2,571.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,117.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,631.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,845.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,662.11
|
| Rate for Payer: UHC Core |
$2,525.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,268.84
|
|
