|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,404.15 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: Aetna Medicare |
$1,537.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,847.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,847.57
|
| Rate for Payer: BCBS Complete |
$2,364.89
|
| Rate for Payer: BCBS MAPPO |
$1,478.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,860.44
|
| Rate for Payer: BCN Commercial |
$4,596.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,478.06
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,478.06
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,434.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,551.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,699.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: Nomi Health Commercial |
$4,848.02
|
| Rate for Payer: PACE Senior Care Partners |
$1,404.15
|
| Rate for Payer: PACE SWMI |
$1,478.06
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,478.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health HMO/PPO |
$5,143.63
|
| Rate for Payer: Priority Health Medicare |
$1,492.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,961.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,478.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,202.75
|
| Rate for Payer: UHC Core |
$4,936.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,478.06
|
| Rate for Payer: UHC Exchange |
$1,478.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,478.06
|
| Rate for Payer: VA VA |
$1,478.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,434.16
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,842.94 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,826.15
|
| Rate for Payer: BCN Commercial |
$4,568.96
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,434.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: Nomi Health Commercial |
$4,848.02
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health HMO/PPO |
$5,143.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,961.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,202.75
|
| Rate for Payer: UHC Core |
$4,936.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,434.16
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,715.33 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: Aetna Medicare |
$1,877.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,257.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,257.02
|
| Rate for Payer: BCBS Complete |
$2,888.98
|
| Rate for Payer: BCBS MAPPO |
$1,805.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,937.58
|
| Rate for Payer: BCN Commercial |
$5,615.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,805.62
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,805.62
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,416.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,895.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,076.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: Nomi Health Commercial |
$5,922.42
|
| Rate for Payer: PACE Senior Care Partners |
$1,715.33
|
| Rate for Payer: PACE SWMI |
$1,805.62
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,805.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.54
|
| Rate for Payer: Priority Health Medicare |
$1,823.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,805.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,355.76
|
| Rate for Payer: UHC Core |
$6,030.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,805.62
|
| Rate for Payer: UHC Exchange |
$1,805.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,805.62
|
| Rate for Payer: VA VA |
$1,805.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,416.85
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,694.60 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: BCBS Trust/PPO |
$5,895.69
|
| Rate for Payer: BCN Commercial |
$5,581.52
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,416.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: Nomi Health Commercial |
$5,922.42
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,355.76
|
| Rate for Payer: UHC Core |
$6,030.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,416.85
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$302.81 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$331.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.44
|
| Rate for Payer: BCBS Complete |
$510.00
|
| Rate for Payer: BCBS MAPPO |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.18
|
| Rate for Payer: BCN Commercial |
$991.31
|
| Rate for Payer: BCN Medicare Advantage |
$318.75
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: PACE Senior Care Partners |
$302.81
|
| Rate for Payer: PACE SWMI |
$318.75
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: PHP Medicare Advantage |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Medicare |
$321.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.25
|
| Rate for Payer: Railroad Medicare Medicare |
$318.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.75
|
| Rate for Payer: UHC Exchange |
$318.75
|
| Rate for Payer: UHC Medicare Advantage |
$318.75
|
| Rate for Payer: VA VA |
$318.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$828.75 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.78
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
OP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.52 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: Aetna Medicare |
$414.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$498.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$498.05
|
| Rate for Payer: BCBS Complete |
$637.50
|
| Rate for Payer: BCBS MAPPO |
$398.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.22
|
| Rate for Payer: BCN Commercial |
$1,239.14
|
| Rate for Payer: BCN Medicare Advantage |
$398.44
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.44
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: PACE Senior Care Partners |
$378.52
|
| Rate for Payer: PACE SWMI |
$398.44
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: PHP Medicare Advantage |
$398.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Medicare |
$402.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.81
|
| Rate for Payer: Railroad Medicare Medicare |
$398.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.44
|
| Rate for Payer: UHC Exchange |
$398.44
|
| Rate for Payer: UHC Medicare Advantage |
$398.44
|
| Rate for Payer: VA VA |
$398.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
IP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,035.94 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.98
|
| Rate for Payer: BCN Commercial |
$1,231.65
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,911.28 |
| Max. Negotiated Rate |
$5,415.62 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,911.97
|
| Rate for Payer: BCN Commercial |
$4,650.22
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,513.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: Nomi Health Commercial |
$4,934.24
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,235.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,031.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,295.28
|
| Rate for Payer: UHC Core |
$5,024.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,513.02
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.12 |
| Max. Negotiated Rate |
$5,415.62 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: Aetna Medicare |
$1,564.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,880.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,880.42
|
| Rate for Payer: BCBS Complete |
$4,429.45
|
| Rate for Payer: BCBS MAPPO |
$1,504.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,946.87
|
| Rate for Payer: BCN Commercial |
$4,678.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,504.34
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,504.34
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,513.02
|
| Rate for Payer: Mclaren Medicaid |
$4,218.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,579.56
|
| Rate for Payer: Meridian Medicaid |
$4,429.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,729.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: Nomi Health Commercial |
$4,934.24
|
| Rate for Payer: PACE Senior Care Partners |
$1,429.12
|
| Rate for Payer: PACE SWMI |
$1,504.34
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,504.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,218.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,235.10
|
| Rate for Payer: Priority Health Medicare |
$1,519.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,031.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,504.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,295.28
|
| Rate for Payer: UHC Core |
$5,024.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,504.34
|
| Rate for Payer: UHC Exchange |
$1,504.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,504.34
|
| Rate for Payer: UHCCP Medicaid |
$4,218.24
|
| Rate for Payer: VA VA |
$1,504.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,513.02
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: Aetna Medicare |
$2,313.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,781.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,781.24
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$2,224.99
|
| Rate for Payer: BCBS Trust/PPO |
$7,316.66
|
| Rate for Payer: BCN Commercial |
$6,919.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,224.99
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,224.99
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,674.97
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,336.24
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,558.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: Nomi Health Commercial |
$7,297.97
|
| Rate for Payer: PACE Senior Care Partners |
$2,113.74
|
| Rate for Payer: PACE SWMI |
$2,224.99
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,224.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health HMO/PPO |
$7,742.97
|
| Rate for Payer: Priority Health Medicare |
$2,247.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,962.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,224.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,831.96
|
| Rate for Payer: UHC Core |
$7,431.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,224.99
|
| Rate for Payer: UHC Exchange |
$2,224.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,224.99
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$2,224.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,674.97
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,784.97 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: BCBS Trust/PPO |
$7,265.04
|
| Rate for Payer: BCN Commercial |
$6,877.89
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,674.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: Nomi Health Commercial |
$7,297.97
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health HMO/PPO |
$7,742.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,962.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,831.96
|
| Rate for Payer: UHC Core |
$7,431.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,674.97
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health HMO/PPO |
$23.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.80
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health HMO/PPO |
$23.07
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.77
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.12 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: BCBS Trust/PPO |
$407.04
|
| Rate for Payer: BCN Commercial |
$385.35
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO |
$433.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.80
|
| Rate for Payer: UHC Core |
$416.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.43 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna Medicare |
$129.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.82
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$124.66
|
| Rate for Payer: BCBS Trust/PPO |
$409.93
|
| Rate for Payer: BCN Commercial |
$387.69
|
| Rate for Payer: BCN Medicare Advantage |
$124.66
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.66
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.89
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: PACE Senior Care Partners |
$118.43
|
| Rate for Payer: PACE SWMI |
$124.66
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: PHP Medicare Advantage |
$124.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO |
$433.82
|
| Rate for Payer: Priority Health Medicare |
$125.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.09
|
| Rate for Payer: Railroad Medicare Medicare |
$124.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.80
|
| Rate for Payer: UHC Core |
$416.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.66
|
| Rate for Payer: UHC Exchange |
$124.66
|
| Rate for Payer: UHC Medicare Advantage |
$124.66
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$124.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$399.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.96 |
| Max. Negotiated Rate |
$359.85 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: Aetna Medicare |
$103.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.95
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$99.96
|
| Rate for Payer: BCBS Trust/PPO |
$328.70
|
| Rate for Payer: BCN Commercial |
$310.87
|
| Rate for Payer: BCN Medicare Advantage |
$99.96
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cofinity Commercial |
$343.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.96
|
| Rate for Payer: Healthscope Commercial |
$359.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.87
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.96
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.86
|
| Rate for Payer: Nomi Health Commercial |
$327.86
|
| Rate for Payer: PACE Senior Care Partners |
$94.96
|
| Rate for Payer: PACE SWMI |
$99.96
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: PHP Medicare Advantage |
$99.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.89
|
| Rate for Payer: Priority Health HMO/PPO |
$347.85
|
| Rate for Payer: Priority Health Medicare |
$100.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.89
|
| Rate for Payer: Railroad Medicare Medicare |
$99.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.85
|
| Rate for Payer: UHC Core |
$333.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.96
|
| Rate for Payer: UHC Exchange |
$99.96
|
| Rate for Payer: UHC Medicare Advantage |
$99.96
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$99.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.87
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$399.83
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$259.89 |
| Max. Negotiated Rate |
$359.85 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: BCBS Trust/PPO |
$326.38
|
| Rate for Payer: BCN Commercial |
$308.99
|
| Rate for Payer: Cash Price |
$319.86
|
| Rate for Payer: Cofinity Commercial |
$343.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.86
|
| Rate for Payer: Healthscope Commercial |
$359.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.86
|
| Rate for Payer: Nomi Health Commercial |
$327.86
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.89
|
| Rate for Payer: Priority Health HMO/PPO |
$347.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.85
|
| Rate for Payer: UHC Core |
$333.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.87
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
OP
|
$1,789.39
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.98 |
| Max. Negotiated Rate |
$1,610.45 |
| Rate for Payer: Aetna Commercial |
$1,520.98
|
| Rate for Payer: Aetna Medicare |
$465.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$559.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$559.18
|
| Rate for Payer: BCBS Complete |
$895.16
|
| Rate for Payer: BCBS MAPPO |
$447.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.06
|
| Rate for Payer: BCN Commercial |
$1,391.25
|
| Rate for Payer: BCN Medicare Advantage |
$447.35
|
| Rate for Payer: Cash Price |
$1,431.51
|
| Rate for Payer: Cash Price |
$1,431.51
|
| Rate for Payer: Cofinity Commercial |
$1,538.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.35
|
| Rate for Payer: Healthscope Commercial |
$1,610.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,342.04
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.71
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.98
|
| Rate for Payer: Nomi Health Commercial |
$1,467.30
|
| Rate for Payer: PACE Senior Care Partners |
$424.98
|
| Rate for Payer: PACE SWMI |
$447.35
|
| Rate for Payer: PHP Commercial |
$1,520.98
|
| Rate for Payer: PHP Medicare Advantage |
$447.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$852.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,163.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.77
|
| Rate for Payer: Priority Health Medicare |
$451.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.89
|
| Rate for Payer: Railroad Medicare Medicare |
$447.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.66
|
| Rate for Payer: UHC Core |
$1,494.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$447.35
|
| Rate for Payer: UHC Exchange |
$447.35
|
| Rate for Payer: UHC Medicare Advantage |
$447.35
|
| Rate for Payer: UHCCP Medicaid |
$852.47
|
| Rate for Payer: VA VA |
$447.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,342.04
|
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
IP
|
$1,789.39
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
36100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,163.10 |
| Max. Negotiated Rate |
$1,610.45 |
| Rate for Payer: Aetna Commercial |
$1,520.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.68
|
| Rate for Payer: BCN Commercial |
$1,382.84
|
| Rate for Payer: Cash Price |
$1,431.51
|
| Rate for Payer: Cofinity Commercial |
$1,538.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.51
|
| Rate for Payer: Healthscope Commercial |
$1,610.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,342.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.98
|
| Rate for Payer: Nomi Health Commercial |
$1,467.30
|
| Rate for Payer: PHP Commercial |
$1,520.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,163.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.66
|
| Rate for Payer: UHC Core |
$1,494.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,342.04
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
IP
|
$195.98
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.39 |
| Max. Negotiated Rate |
$176.38 |
| Rate for Payer: Aetna Commercial |
$166.58
|
| Rate for Payer: BCBS Trust/PPO |
$159.98
|
| Rate for Payer: BCN Commercial |
$151.45
|
| Rate for Payer: Cash Price |
$156.78
|
| Rate for Payer: Cofinity Commercial |
$168.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.78
|
| Rate for Payer: Healthscope Commercial |
$176.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.58
|
| Rate for Payer: Nomi Health Commercial |
$160.70
|
| Rate for Payer: PHP Commercial |
$166.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.39
|
| Rate for Payer: Priority Health HMO/PPO |
$170.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.46
|
| Rate for Payer: UHC Core |
$163.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.99
|
|
|
HC ACAPELLA SUPPLY
|
Facility
|
OP
|
$195.98
|
|
| Hospital Charge Code |
27000025
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.55 |
| Max. Negotiated Rate |
$176.38 |
| Rate for Payer: Aetna Commercial |
$166.58
|
| Rate for Payer: Aetna Medicare |
$50.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.24
|
| Rate for Payer: BCBS Complete |
$78.39
|
| Rate for Payer: BCBS MAPPO |
$48.99
|
| Rate for Payer: BCBS Trust/PPO |
$161.12
|
| Rate for Payer: BCN Commercial |
$152.37
|
| Rate for Payer: BCN Medicare Advantage |
$48.99
|
| Rate for Payer: Cash Price |
$156.78
|
| Rate for Payer: Cofinity Commercial |
$168.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.99
|
| Rate for Payer: Healthscope Commercial |
$176.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.58
|
| Rate for Payer: Nomi Health Commercial |
$160.70
|
| Rate for Payer: PACE Senior Care Partners |
$46.55
|
| Rate for Payer: PACE SWMI |
$48.99
|
| Rate for Payer: PHP Commercial |
$166.58
|
| Rate for Payer: PHP Medicare Advantage |
$48.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.39
|
| Rate for Payer: Priority Health HMO/PPO |
$170.50
|
| Rate for Payer: Priority Health Medicare |
$49.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.31
|
| Rate for Payer: Railroad Medicare Medicare |
$48.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.46
|
| Rate for Payer: UHC Core |
$163.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.99
|
| Rate for Payer: UHC Exchange |
$48.99
|
| Rate for Payer: UHC Medicare Advantage |
$48.99
|
| Rate for Payer: VA VA |
$48.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.99
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
IP
|
$94.29
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.29 |
| Max. Negotiated Rate |
$84.86 |
| Rate for Payer: Aetna Commercial |
$80.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.97
|
| Rate for Payer: BCN Commercial |
$72.87
|
| Rate for Payer: Cash Price |
$75.43
|
| Rate for Payer: Cofinity Commercial |
$81.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.43
|
| Rate for Payer: Healthscope Commercial |
$84.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.15
|
| Rate for Payer: Nomi Health Commercial |
$77.32
|
| Rate for Payer: PHP Commercial |
$80.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.29
|
| Rate for Payer: Priority Health HMO/PPO |
$82.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.98
|
| Rate for Payer: UHC Core |
$78.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.72
|
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
OP
|
$94.29
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600031
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.39 |
| Max. Negotiated Rate |
$84.86 |
| Rate for Payer: Aetna Commercial |
$80.15
|
| Rate for Payer: Aetna Medicare |
$24.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.47
|
| Rate for Payer: BCBS Complete |
$37.72
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$77.52
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$75.43
|
| Rate for Payer: Cofinity Commercial |
$81.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$84.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.15
|
| Rate for Payer: Nomi Health Commercial |
$77.32
|
| Rate for Payer: PACE Senior Care Partners |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$80.15
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.29
|
| Rate for Payer: Priority Health HMO/PPO |
$82.03
|
| Rate for Payer: Priority Health Medicare |
$23.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.98
|
| Rate for Payer: UHC Core |
$78.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: VA VA |
$23.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.72
|
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
IP
|
$355.31
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000072
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$230.95 |
| Max. Negotiated Rate |
$319.78 |
| Rate for Payer: Aetna Commercial |
$302.01
|
| Rate for Payer: BCBS Trust/PPO |
$290.04
|
| Rate for Payer: BCN Commercial |
$274.58
|
| Rate for Payer: Cash Price |
$284.25
|
| Rate for Payer: Cofinity Commercial |
$305.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
| Rate for Payer: Healthscope Commercial |
$319.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.01
|
| Rate for Payer: Nomi Health Commercial |
$291.35
|
| Rate for Payer: PHP Commercial |
$302.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.95
|
| Rate for Payer: Priority Health HMO/PPO |
$309.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.67
|
| Rate for Payer: UHC Core |
$296.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.48
|
|
