|
HC BALLOON CATH TRANSLUMINAL LVL 10
|
Facility
|
IP
|
$1,041.42
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$724.83 |
| Max. Negotiated Rate |
$937.28 |
| Rate for Payer: Aetna Commercial |
$885.21
|
| Rate for Payer: BCBS Trust/PPO |
$860.11
|
| Rate for Payer: BCN Commercial |
$860.11
|
| Rate for Payer: Cash Price |
$833.14
|
| Rate for Payer: Cofinity Commercial |
$895.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.14
|
| Rate for Payer: Healthscope Commercial |
$937.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.21
|
| Rate for Payer: Nomi Health Commercial |
$853.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.07
|
| Rate for Payer: PHP Commercial |
$885.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.45
|
| Rate for Payer: UHC Core |
$869.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.07
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 12
|
Facility
|
OP
|
$1,289.14
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$227.28 |
| Max. Negotiated Rate |
$1,160.23 |
| Rate for Payer: Aetna Commercial |
$1,095.77
|
| Rate for Payer: Aetna Medicare |
$335.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$402.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$402.86
|
| Rate for Payer: BCBS Complete |
$238.62
|
| Rate for Payer: BCBS MAPPO |
$322.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,059.80
|
| Rate for Payer: BCN Commercial |
$1,059.80
|
| Rate for Payer: BCN Medicare Advantage |
$322.29
|
| Rate for Payer: Cash Price |
$1,031.31
|
| Rate for Payer: Cofinity Commercial |
$1,108.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.29
|
| Rate for Payer: Healthscope Commercial |
$1,160.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.86
|
| Rate for Payer: Mclaren Medicaid |
$227.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.40
|
| Rate for Payer: Meridian Medicaid |
$238.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$370.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$354.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.77
|
| Rate for Payer: Nomi Health Commercial |
$1,057.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$966.86
|
| Rate for Payer: PACE Senior Care Partners |
$306.17
|
| Rate for Payer: PACE SWMI |
$322.29
|
| Rate for Payer: PHP Commercial |
$1,095.77
|
| Rate for Payer: PHP Medicare Advantage |
$322.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,121.55
|
| Rate for Payer: Priority Health Medicare |
$325.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.24
|
| Rate for Payer: Railroad Medicare Medicare |
$322.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.44
|
| Rate for Payer: UHC Core |
$1,076.43
|
| Rate for Payer: UHC Exchange |
$322.29
|
| Rate for Payer: UHC Medicaid |
$227.28
|
| Rate for Payer: UHC Medicare Advantage |
$322.29
|
| Rate for Payer: UHCCP Medicaid |
$227.28
|
| Rate for Payer: VA VA |
$322.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.86
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 12
|
Facility
|
IP
|
$1,289.14
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$897.24 |
| Max. Negotiated Rate |
$1,160.23 |
| Rate for Payer: Aetna Commercial |
$1,095.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,064.70
|
| Rate for Payer: BCN Commercial |
$1,064.70
|
| Rate for Payer: Cash Price |
$1,031.31
|
| Rate for Payer: Cofinity Commercial |
$1,108.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.31
|
| Rate for Payer: Healthscope Commercial |
$1,160.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.77
|
| Rate for Payer: Nomi Health Commercial |
$1,057.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$966.86
|
| Rate for Payer: PHP Commercial |
$1,095.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,121.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.44
|
| Rate for Payer: UHC Core |
$1,076.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.86
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 15
|
Facility
|
OP
|
$1,553.34
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$273.85 |
| Max. Negotiated Rate |
$1,398.01 |
| Rate for Payer: Aetna Commercial |
$1,320.34
|
| Rate for Payer: Aetna Medicare |
$403.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$485.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$485.42
|
| Rate for Payer: BCBS Complete |
$287.52
|
| Rate for Payer: BCBS MAPPO |
$388.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.00
|
| Rate for Payer: BCN Commercial |
$1,277.00
|
| Rate for Payer: BCN Medicare Advantage |
$388.33
|
| Rate for Payer: Cash Price |
$1,242.67
|
| Rate for Payer: Cofinity Commercial |
$1,335.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,242.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.33
|
| Rate for Payer: Healthscope Commercial |
$1,398.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,165.01
|
| Rate for Payer: Mclaren Medicaid |
$273.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.75
|
| Rate for Payer: Meridian Medicaid |
$287.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$446.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$427.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,320.34
|
| Rate for Payer: Nomi Health Commercial |
$1,273.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,165.01
|
| Rate for Payer: PACE Senior Care Partners |
$368.92
|
| Rate for Payer: PACE SWMI |
$388.33
|
| Rate for Payer: PHP Commercial |
$1,320.34
|
| Rate for Payer: PHP Medicare Advantage |
$388.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,351.41
|
| Rate for Payer: Priority Health Medicare |
$392.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.12
|
| Rate for Payer: Railroad Medicare Medicare |
$388.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,366.94
|
| Rate for Payer: UHC Core |
$1,297.04
|
| Rate for Payer: UHC Exchange |
$388.33
|
| Rate for Payer: UHC Medicaid |
$273.85
|
| Rate for Payer: UHC Medicare Advantage |
$388.33
|
| Rate for Payer: UHCCP Medicaid |
$273.85
|
| Rate for Payer: VA VA |
$388.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,165.01
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 15
|
Facility
|
IP
|
$1,553.34
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,081.12 |
| Max. Negotiated Rate |
$1,398.01 |
| Rate for Payer: Aetna Commercial |
$1,320.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.90
|
| Rate for Payer: BCN Commercial |
$1,282.90
|
| Rate for Payer: Cash Price |
$1,242.67
|
| Rate for Payer: Cofinity Commercial |
$1,335.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,242.67
|
| Rate for Payer: Healthscope Commercial |
$1,398.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,165.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,320.34
|
| Rate for Payer: Nomi Health Commercial |
$1,273.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,165.01
|
| Rate for Payer: PHP Commercial |
$1,320.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,351.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,366.94
|
| Rate for Payer: UHC Core |
$1,297.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,165.01
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 16
|
Facility
|
IP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,131.00 |
| Max. Negotiated Rate |
$1,462.50 |
| Rate for Payer: Aetna Commercial |
$1,381.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.09
|
| Rate for Payer: BCN Commercial |
$1,342.09
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$1,397.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,300.00
|
| Rate for Payer: Healthscope Commercial |
$1,462.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,218.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,381.25
|
| Rate for Payer: Nomi Health Commercial |
$1,332.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.75
|
| Rate for Payer: PHP Commercial |
$1,381.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,413.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.00
|
| Rate for Payer: UHC Core |
$1,356.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,218.75
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 16
|
Facility
|
OP
|
$1,625.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$286.49 |
| Max. Negotiated Rate |
$1,462.50 |
| Rate for Payer: Aetna Commercial |
$1,381.25
|
| Rate for Payer: Aetna Medicare |
$422.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$507.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$507.81
|
| Rate for Payer: BCBS Complete |
$300.79
|
| Rate for Payer: BCBS MAPPO |
$406.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,335.91
|
| Rate for Payer: BCN Commercial |
$1,335.91
|
| Rate for Payer: BCN Medicare Advantage |
$406.25
|
| Rate for Payer: Cash Price |
$1,300.00
|
| Rate for Payer: Cofinity Commercial |
$1,397.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$406.25
|
| Rate for Payer: Healthscope Commercial |
$1,462.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,218.75
|
| Rate for Payer: Mclaren Medicaid |
$286.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$426.56
|
| Rate for Payer: Meridian Medicaid |
$300.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$467.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$446.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,381.25
|
| Rate for Payer: Nomi Health Commercial |
$1,332.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,218.75
|
| Rate for Payer: PACE Senior Care Partners |
$385.94
|
| Rate for Payer: PACE SWMI |
$406.25
|
| Rate for Payer: PHP Commercial |
$1,381.25
|
| Rate for Payer: PHP Medicare Advantage |
$406.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,413.75
|
| Rate for Payer: Priority Health Medicare |
$410.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.00
|
| Rate for Payer: Railroad Medicare Medicare |
$406.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,430.00
|
| Rate for Payer: UHC Core |
$1,356.88
|
| Rate for Payer: UHC Exchange |
$406.25
|
| Rate for Payer: UHC Medicaid |
$286.49
|
| Rate for Payer: UHC Medicare Advantage |
$406.25
|
| Rate for Payer: UHCCP Medicaid |
$286.49
|
| Rate for Payer: VA VA |
$406.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,218.75
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 24
|
Facility
|
OP
|
$2,448.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$431.58 |
| Max. Negotiated Rate |
$2,203.20 |
| Rate for Payer: Aetna Commercial |
$2,080.80
|
| Rate for Payer: Aetna Medicare |
$636.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$765.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$765.00
|
| Rate for Payer: BCBS Complete |
$453.12
|
| Rate for Payer: BCBS MAPPO |
$612.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,012.50
|
| Rate for Payer: BCN Commercial |
$2,012.50
|
| Rate for Payer: BCN Medicare Advantage |
$612.00
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$2,105.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$2,203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,836.00
|
| Rate for Payer: Mclaren Medicaid |
$431.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.60
|
| Rate for Payer: Meridian Medicaid |
$453.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$703.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$673.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: Nomi Health Commercial |
$2,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.00
|
| Rate for Payer: PACE Senior Care Partners |
$581.40
|
| Rate for Payer: PACE SWMI |
$612.00
|
| Rate for Payer: PHP Commercial |
$2,080.80
|
| Rate for Payer: PHP Medicare Advantage |
$612.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,129.76
|
| Rate for Payer: Priority Health Medicare |
$618.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,703.81
|
| Rate for Payer: Railroad Medicare Medicare |
$612.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,154.24
|
| Rate for Payer: UHC Core |
$2,044.08
|
| Rate for Payer: UHC Exchange |
$612.00
|
| Rate for Payer: UHC Medicaid |
$431.58
|
| Rate for Payer: UHC Medicare Advantage |
$612.00
|
| Rate for Payer: UHCCP Medicaid |
$431.58
|
| Rate for Payer: VA VA |
$612.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,836.00
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 24
|
Facility
|
IP
|
$2,448.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,703.81 |
| Max. Negotiated Rate |
$2,203.20 |
| Rate for Payer: Aetna Commercial |
$2,080.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.80
|
| Rate for Payer: BCN Commercial |
$2,021.80
|
| Rate for Payer: Cash Price |
$1,958.40
|
| Rate for Payer: Cofinity Commercial |
$2,105.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,958.40
|
| Rate for Payer: Healthscope Commercial |
$2,203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,836.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,080.80
|
| Rate for Payer: Nomi Health Commercial |
$2,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,836.00
|
| Rate for Payer: PHP Commercial |
$2,080.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,129.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,703.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,154.24
|
| Rate for Payer: UHC Core |
$2,044.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,836.00
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 4
|
Facility
|
IP
|
$421.04
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$293.04 |
| Max. Negotiated Rate |
$378.94 |
| Rate for Payer: Aetna Commercial |
$357.88
|
| Rate for Payer: BCBS Trust/PPO |
$347.74
|
| Rate for Payer: BCN Commercial |
$347.74
|
| Rate for Payer: Cash Price |
$336.83
|
| Rate for Payer: Cofinity Commercial |
$362.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.83
|
| Rate for Payer: Healthscope Commercial |
$378.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.88
|
| Rate for Payer: Nomi Health Commercial |
$345.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.78
|
| Rate for Payer: PHP Commercial |
$357.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$366.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.52
|
| Rate for Payer: UHC Core |
$351.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.78
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 4
|
Facility
|
OP
|
$421.04
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.23 |
| Max. Negotiated Rate |
$378.94 |
| Rate for Payer: Aetna Commercial |
$357.88
|
| Rate for Payer: Aetna Medicare |
$109.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.57
|
| Rate for Payer: BCBS Complete |
$77.93
|
| Rate for Payer: BCBS MAPPO |
$105.26
|
| Rate for Payer: BCBS Trust/PPO |
$346.14
|
| Rate for Payer: BCN Commercial |
$346.14
|
| Rate for Payer: BCN Medicare Advantage |
$105.26
|
| Rate for Payer: Cash Price |
$336.83
|
| Rate for Payer: Cofinity Commercial |
$362.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$378.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.78
|
| Rate for Payer: Mclaren Medicaid |
$74.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.52
|
| Rate for Payer: Meridian Medicaid |
$77.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.88
|
| Rate for Payer: Nomi Health Commercial |
$345.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.78
|
| Rate for Payer: PACE Senior Care Partners |
$100.00
|
| Rate for Payer: PACE SWMI |
$105.26
|
| Rate for Payer: PHP Commercial |
$357.88
|
| Rate for Payer: PHP Medicare Advantage |
$105.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$366.30
|
| Rate for Payer: Priority Health Medicare |
$106.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.04
|
| Rate for Payer: Railroad Medicare Medicare |
$105.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.52
|
| Rate for Payer: UHC Core |
$351.57
|
| Rate for Payer: UHC Exchange |
$105.26
|
| Rate for Payer: UHC Medicaid |
$74.23
|
| Rate for Payer: UHC Medicare Advantage |
$105.26
|
| Rate for Payer: UHCCP Medicaid |
$74.23
|
| Rate for Payer: VA VA |
$105.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.78
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 5
|
Facility
|
IP
|
$588.11
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$409.32 |
| Max. Negotiated Rate |
$529.30 |
| Rate for Payer: Aetna Commercial |
$499.89
|
| Rate for Payer: BCBS Trust/PPO |
$485.72
|
| Rate for Payer: BCN Commercial |
$485.72
|
| Rate for Payer: Cash Price |
$470.49
|
| Rate for Payer: Cofinity Commercial |
$505.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.49
|
| Rate for Payer: Healthscope Commercial |
$529.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.89
|
| Rate for Payer: Nomi Health Commercial |
$482.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$441.08
|
| Rate for Payer: PHP Commercial |
$499.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.54
|
| Rate for Payer: UHC Core |
$491.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.08
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 5
|
Facility
|
OP
|
$588.11
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200078
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$103.68 |
| Max. Negotiated Rate |
$529.30 |
| Rate for Payer: Aetna Commercial |
$499.89
|
| Rate for Payer: Aetna Medicare |
$152.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.78
|
| Rate for Payer: BCBS Complete |
$108.86
|
| Rate for Payer: BCBS MAPPO |
$147.03
|
| Rate for Payer: BCBS Trust/PPO |
$483.49
|
| Rate for Payer: BCN Commercial |
$483.49
|
| Rate for Payer: BCN Medicare Advantage |
$147.03
|
| Rate for Payer: Cash Price |
$470.49
|
| Rate for Payer: Cofinity Commercial |
$505.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.03
|
| Rate for Payer: Healthscope Commercial |
$529.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.08
|
| Rate for Payer: Mclaren Medicaid |
$103.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.38
|
| Rate for Payer: Meridian Medicaid |
$108.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.89
|
| Rate for Payer: Nomi Health Commercial |
$482.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$441.08
|
| Rate for Payer: PACE Senior Care Partners |
$139.68
|
| Rate for Payer: PACE SWMI |
$147.03
|
| Rate for Payer: PHP Commercial |
$499.89
|
| Rate for Payer: PHP Medicare Advantage |
$147.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.66
|
| Rate for Payer: Priority Health Medicare |
$148.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.32
|
| Rate for Payer: Railroad Medicare Medicare |
$147.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.54
|
| Rate for Payer: UHC Core |
$491.07
|
| Rate for Payer: UHC Exchange |
$147.03
|
| Rate for Payer: UHC Medicaid |
$103.68
|
| Rate for Payer: UHC Medicare Advantage |
$147.03
|
| Rate for Payer: UHCCP Medicaid |
$103.68
|
| Rate for Payer: VA VA |
$147.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.08
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 6
|
Facility
|
OP
|
$691.56
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.92 |
| Max. Negotiated Rate |
$622.40 |
| Rate for Payer: Aetna Commercial |
$587.83
|
| Rate for Payer: Aetna Medicare |
$179.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$216.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$216.11
|
| Rate for Payer: BCBS Complete |
$128.01
|
| Rate for Payer: BCBS MAPPO |
$172.89
|
| Rate for Payer: BCBS Trust/PPO |
$568.53
|
| Rate for Payer: BCN Commercial |
$568.53
|
| Rate for Payer: BCN Medicare Advantage |
$172.89
|
| Rate for Payer: Cash Price |
$553.25
|
| Rate for Payer: Cofinity Commercial |
$594.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.89
|
| Rate for Payer: Healthscope Commercial |
$622.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.67
|
| Rate for Payer: Mclaren Medicaid |
$121.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.53
|
| Rate for Payer: Meridian Medicaid |
$128.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.83
|
| Rate for Payer: Nomi Health Commercial |
$567.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.67
|
| Rate for Payer: PACE Senior Care Partners |
$164.25
|
| Rate for Payer: PACE SWMI |
$172.89
|
| Rate for Payer: PHP Commercial |
$587.83
|
| Rate for Payer: PHP Medicare Advantage |
$172.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$601.66
|
| Rate for Payer: Priority Health Medicare |
$174.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.33
|
| Rate for Payer: Railroad Medicare Medicare |
$172.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.57
|
| Rate for Payer: UHC Core |
$577.45
|
| Rate for Payer: UHC Exchange |
$172.89
|
| Rate for Payer: UHC Medicaid |
$121.92
|
| Rate for Payer: UHC Medicare Advantage |
$172.89
|
| Rate for Payer: UHCCP Medicaid |
$121.92
|
| Rate for Payer: VA VA |
$172.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.67
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 6
|
Facility
|
IP
|
$691.56
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$481.33 |
| Max. Negotiated Rate |
$622.40 |
| Rate for Payer: Aetna Commercial |
$587.83
|
| Rate for Payer: BCBS Trust/PPO |
$571.16
|
| Rate for Payer: BCN Commercial |
$571.16
|
| Rate for Payer: Cash Price |
$553.25
|
| Rate for Payer: Cofinity Commercial |
$594.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.25
|
| Rate for Payer: Healthscope Commercial |
$622.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.83
|
| Rate for Payer: Nomi Health Commercial |
$567.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.67
|
| Rate for Payer: PHP Commercial |
$587.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$601.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.57
|
| Rate for Payer: UHC Core |
$577.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.67
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 69
|
Facility
|
IP
|
$6,937.70
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,828.64 |
| Max. Negotiated Rate |
$6,243.93 |
| Rate for Payer: Aetna Commercial |
$5,897.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,729.85
|
| Rate for Payer: BCN Commercial |
$5,729.85
|
| Rate for Payer: Cash Price |
$5,550.16
|
| Rate for Payer: Cofinity Commercial |
$5,966.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,550.16
|
| Rate for Payer: Healthscope Commercial |
$6,243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,203.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,897.05
|
| Rate for Payer: Nomi Health Commercial |
$5,688.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,203.27
|
| Rate for Payer: PHP Commercial |
$5,897.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,035.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,828.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,105.18
|
| Rate for Payer: UHC Core |
$5,792.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,203.27
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 69
|
Facility
|
OP
|
$6,937.70
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,223.12 |
| Max. Negotiated Rate |
$6,243.93 |
| Rate for Payer: Aetna Commercial |
$5,897.05
|
| Rate for Payer: Aetna Medicare |
$1,803.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,168.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,168.03
|
| Rate for Payer: BCBS Complete |
$1,284.17
|
| Rate for Payer: BCBS MAPPO |
$1,734.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,703.48
|
| Rate for Payer: BCN Commercial |
$5,703.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,734.42
|
| Rate for Payer: Cash Price |
$5,550.16
|
| Rate for Payer: Cofinity Commercial |
$5,966.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,550.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.42
|
| Rate for Payer: Healthscope Commercial |
$6,243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,203.27
|
| Rate for Payer: Mclaren Medicaid |
$1,223.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,821.15
|
| Rate for Payer: Meridian Medicaid |
$1,284.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,994.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,907.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,897.05
|
| Rate for Payer: Nomi Health Commercial |
$5,688.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,203.27
|
| Rate for Payer: PACE Senior Care Partners |
$1,647.70
|
| Rate for Payer: PACE SWMI |
$1,734.42
|
| Rate for Payer: PHP Commercial |
$5,897.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,734.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,223.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,035.80
|
| Rate for Payer: Priority Health Medicare |
$1,751.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,828.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,734.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,105.18
|
| Rate for Payer: UHC Core |
$5,792.98
|
| Rate for Payer: UHC Exchange |
$1,734.42
|
| Rate for Payer: UHC Medicaid |
$1,223.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,734.42
|
| Rate for Payer: UHCCP Medicaid |
$1,223.12
|
| Rate for Payer: VA VA |
$1,734.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,203.27
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 7
|
Facility
|
OP
|
$734.40
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$129.47 |
| Max. Negotiated Rate |
$660.96 |
| Rate for Payer: Aetna Commercial |
$624.24
|
| Rate for Payer: Aetna Medicare |
$190.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.50
|
| Rate for Payer: BCBS Complete |
$135.94
|
| Rate for Payer: BCBS MAPPO |
$183.60
|
| Rate for Payer: BCBS Trust/PPO |
$603.75
|
| Rate for Payer: BCN Commercial |
$603.75
|
| Rate for Payer: BCN Medicare Advantage |
$183.60
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$631.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$660.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.80
|
| Rate for Payer: Mclaren Medicaid |
$129.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.78
|
| Rate for Payer: Meridian Medicaid |
$135.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.80
|
| Rate for Payer: PACE Senior Care Partners |
$174.42
|
| Rate for Payer: PACE SWMI |
$183.60
|
| Rate for Payer: PHP Commercial |
$624.24
|
| Rate for Payer: PHP Medicare Advantage |
$183.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$638.93
|
| Rate for Payer: Priority Health Medicare |
$185.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$511.14
|
| Rate for Payer: Railroad Medicare Medicare |
$183.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.27
|
| Rate for Payer: UHC Core |
$613.22
|
| Rate for Payer: UHC Exchange |
$183.60
|
| Rate for Payer: UHC Medicaid |
$129.47
|
| Rate for Payer: UHC Medicare Advantage |
$183.60
|
| Rate for Payer: UHCCP Medicaid |
$129.47
|
| Rate for Payer: VA VA |
$183.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.80
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 7
|
Facility
|
IP
|
$734.40
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$511.14 |
| Max. Negotiated Rate |
$660.96 |
| Rate for Payer: Aetna Commercial |
$624.24
|
| Rate for Payer: BCBS Trust/PPO |
$606.54
|
| Rate for Payer: BCN Commercial |
$606.54
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$631.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$660.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.80
|
| Rate for Payer: PHP Commercial |
$624.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$638.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$511.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.27
|
| Rate for Payer: UHC Core |
$613.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.80
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 8
|
Facility
|
OP
|
$886.79
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200264
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.34 |
| Max. Negotiated Rate |
$798.11 |
| Rate for Payer: Aetna Commercial |
$753.77
|
| Rate for Payer: Aetna Medicare |
$230.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$277.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$277.12
|
| Rate for Payer: BCBS Complete |
$164.14
|
| Rate for Payer: BCBS MAPPO |
$221.70
|
| Rate for Payer: BCBS Trust/PPO |
$729.03
|
| Rate for Payer: BCN Commercial |
$729.03
|
| Rate for Payer: BCN Medicare Advantage |
$221.70
|
| Rate for Payer: Cash Price |
$709.43
|
| Rate for Payer: Cofinity Commercial |
$762.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.70
|
| Rate for Payer: Healthscope Commercial |
$798.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.09
|
| Rate for Payer: Mclaren Medicaid |
$156.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.78
|
| Rate for Payer: Meridian Medicaid |
$164.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$753.77
|
| Rate for Payer: Nomi Health Commercial |
$727.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.09
|
| Rate for Payer: PACE Senior Care Partners |
$210.61
|
| Rate for Payer: PACE SWMI |
$221.70
|
| Rate for Payer: PHP Commercial |
$753.77
|
| Rate for Payer: PHP Medicare Advantage |
$221.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.51
|
| Rate for Payer: Priority Health Medicare |
$223.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.21
|
| Rate for Payer: Railroad Medicare Medicare |
$221.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.38
|
| Rate for Payer: UHC Core |
$740.47
|
| Rate for Payer: UHC Exchange |
$221.70
|
| Rate for Payer: UHC Medicaid |
$156.34
|
| Rate for Payer: UHC Medicare Advantage |
$221.70
|
| Rate for Payer: UHCCP Medicaid |
$156.34
|
| Rate for Payer: VA VA |
$221.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.09
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 8
|
Facility
|
IP
|
$886.79
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200264
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$617.21 |
| Max. Negotiated Rate |
$798.11 |
| Rate for Payer: Aetna Commercial |
$753.77
|
| Rate for Payer: BCBS Trust/PPO |
$732.40
|
| Rate for Payer: BCN Commercial |
$732.40
|
| Rate for Payer: Cash Price |
$709.43
|
| Rate for Payer: Cofinity Commercial |
$762.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.43
|
| Rate for Payer: Healthscope Commercial |
$798.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$753.77
|
| Rate for Payer: Nomi Health Commercial |
$727.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.09
|
| Rate for Payer: PHP Commercial |
$753.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.38
|
| Rate for Payer: UHC Core |
$740.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.09
|
|
|
HC BALLOON DILITATION URETER
|
Facility
|
IP
|
$763.51
|
|
|
Service Code
|
CPT 50706
|
| Hospital Charge Code |
36100512
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.40 |
| Max. Negotiated Rate |
$687.16 |
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: BCBS Trust/PPO |
$630.58
|
| Rate for Payer: BCN Commercial |
$630.58
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Commercial |
$656.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Healthscope Commercial |
$687.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Nomi Health Commercial |
$626.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: PHP Commercial |
$648.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$664.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.89
|
| Rate for Payer: UHC Core |
$637.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.63
|
|
|
HC BALLOON DILITATION URETER
|
Facility
|
OP
|
$763.51
|
|
|
Service Code
|
CPT 50706
|
| Hospital Charge Code |
36100512
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$134.61 |
| Max. Negotiated Rate |
$687.16 |
| Rate for Payer: Aetna Commercial |
$648.98
|
| Rate for Payer: Aetna Medicare |
$198.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$238.60
|
| Rate for Payer: BCBS Complete |
$141.33
|
| Rate for Payer: BCBS MAPPO |
$190.88
|
| Rate for Payer: BCBS Trust/PPO |
$627.68
|
| Rate for Payer: BCN Commercial |
$627.68
|
| Rate for Payer: BCN Medicare Advantage |
$190.88
|
| Rate for Payer: Cash Price |
$610.81
|
| Rate for Payer: Cofinity Commercial |
$656.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.88
|
| Rate for Payer: Healthscope Commercial |
$687.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.63
|
| Rate for Payer: Mclaren Medicaid |
$134.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.42
|
| Rate for Payer: Meridian Medicaid |
$141.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$648.98
|
| Rate for Payer: Nomi Health Commercial |
$626.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$572.63
|
| Rate for Payer: PACE Senior Care Partners |
$181.33
|
| Rate for Payer: PACE SWMI |
$190.88
|
| Rate for Payer: PHP Commercial |
$648.98
|
| Rate for Payer: PHP Medicare Advantage |
$190.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$664.25
|
| Rate for Payer: Priority Health Medicare |
$192.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.40
|
| Rate for Payer: Railroad Medicare Medicare |
$190.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.89
|
| Rate for Payer: UHC Core |
$637.53
|
| Rate for Payer: UHC Exchange |
$190.88
|
| Rate for Payer: UHC Medicaid |
$134.61
|
| Rate for Payer: UHC Medicare Advantage |
$190.88
|
| Rate for Payer: UHCCP Medicaid |
$134.61
|
| Rate for Payer: VA VA |
$190.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.63
|
|
|
HC BALLOON PUMP SETUP
|
Facility
|
IP
|
$1,963.53
|
|
| Hospital Charge Code |
27000090
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,366.62 |
| Max. Negotiated Rate |
$1,767.18 |
| Rate for Payer: Aetna Commercial |
$1,669.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,621.68
|
| Rate for Payer: BCN Commercial |
$1,621.68
|
| Rate for Payer: Cash Price |
$1,570.82
|
| Rate for Payer: Cofinity Commercial |
$1,688.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,570.82
|
| Rate for Payer: Healthscope Commercial |
$1,767.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.00
|
| Rate for Payer: Nomi Health Commercial |
$1,610.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,472.65
|
| Rate for Payer: PHP Commercial |
$1,669.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,708.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,366.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.91
|
| Rate for Payer: UHC Core |
$1,639.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.65
|
|
|
HC BALLOON PUMP SETUP
|
Facility
|
OP
|
$1,963.53
|
|
| Hospital Charge Code |
27000090
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$346.17 |
| Max. Negotiated Rate |
$1,767.18 |
| Rate for Payer: Aetna Commercial |
$1,669.00
|
| Rate for Payer: Aetna Medicare |
$510.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$613.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$613.60
|
| Rate for Payer: BCBS Complete |
$363.45
|
| Rate for Payer: BCBS MAPPO |
$490.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.22
|
| Rate for Payer: BCN Commercial |
$1,614.22
|
| Rate for Payer: BCN Medicare Advantage |
$490.88
|
| Rate for Payer: Cash Price |
$1,570.82
|
| Rate for Payer: Cofinity Commercial |
$1,688.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,570.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.88
|
| Rate for Payer: Healthscope Commercial |
$1,767.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.65
|
| Rate for Payer: Mclaren Medicaid |
$346.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.43
|
| Rate for Payer: Meridian Medicaid |
$363.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$564.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$539.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.00
|
| Rate for Payer: Nomi Health Commercial |
$1,610.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,472.65
|
| Rate for Payer: PACE Senior Care Partners |
$466.34
|
| Rate for Payer: PACE SWMI |
$490.88
|
| Rate for Payer: PHP Commercial |
$1,669.00
|
| Rate for Payer: PHP Medicare Advantage |
$490.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$346.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,708.27
|
| Rate for Payer: Priority Health Medicare |
$495.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,366.62
|
| Rate for Payer: Railroad Medicare Medicare |
$490.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.91
|
| Rate for Payer: UHC Core |
$1,639.55
|
| Rate for Payer: UHC Exchange |
$490.88
|
| Rate for Payer: UHC Medicaid |
$346.17
|
| Rate for Payer: UHC Medicare Advantage |
$490.88
|
| Rate for Payer: UHCCP Medicaid |
$346.17
|
| Rate for Payer: VA VA |
$490.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.65
|
|
