|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$301.90 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: BCBS Trust/PPO |
$382.54
|
| Rate for Payer: BCN Commercial |
$382.54
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.60
|
| Rate for Payer: UHC Core |
$413.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
OP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,175.62 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: Aetna Medicare |
$1,287.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,546.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,546.88
|
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: BCBS MAPPO |
$1,237.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,848.62
|
| Rate for Payer: BCN Commercial |
$3,848.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,237.50
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,237.50
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,299.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,423.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,207.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,175.62
|
| Rate for Payer: PACE SWMI |
$1,237.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,237.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,306.50
|
| Rate for Payer: Priority Health Medicare |
$1,237.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,019.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,237.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,356.00
|
| Rate for Payer: UHC Core |
$4,133.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,237.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,274.62
|
| Rate for Payer: VA VA |
$1,237.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Facility
|
IP
|
$4,950.00
|
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,019.00 |
| Max. Negotiated Rate |
$4,455.00 |
| Rate for Payer: Aetna Commercial |
$4,207.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,825.36
|
| Rate for Payer: BCN Commercial |
$3,825.36
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Cofinity Commercial |
$4,257.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,960.00
|
| Rate for Payer: Healthscope Commercial |
$4,455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,207.50
|
| Rate for Payer: PHP Commercial |
$4,207.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,306.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,019.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,356.00
|
| Rate for Payer: UHC Core |
$4,133.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,712.50
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$4,950.00
|
|
|
Service Code
|
HCPCS 00604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$3,465.00 |
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
|
|
HC DEVICE NOT RETURNED WATCHPAT
|
Professional
|
Both
|
$4,950.00
|
|
|
Service Code
|
HCPCS 00604
|
| Hospital Charge Code |
27000604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,980.00 |
| Max. Negotiated Rate |
$3,465.00 |
| Rate for Payer: BCBS Complete |
$1,980.00
|
| Rate for Payer: Cash Price |
$3,960.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,465.00
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
IP
|
$531.00
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.86 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Aetna Commercial |
$451.35
|
| Rate for Payer: BCBS Trust/PPO |
$410.36
|
| Rate for Payer: BCN Commercial |
$410.36
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$456.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.80
|
| Rate for Payer: Healthscope Commercial |
$477.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.35
|
| Rate for Payer: PHP Commercial |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.28
|
| Rate for Payer: UHC Core |
$443.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.25
|
|
|
HC DEXA BONE DENSITY
|
Facility
|
OP
|
$531.00
|
|
|
Service Code
|
CPT 77080
|
| Hospital Charge Code |
32000260
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Aetna Commercial |
$451.35
|
| Rate for Payer: Aetna Medicare |
$138.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.94
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$132.75
|
| Rate for Payer: BCBS Trust/PPO |
$412.85
|
| Rate for Payer: BCN Commercial |
$412.85
|
| Rate for Payer: BCN Medicare Advantage |
$132.75
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$456.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.75
|
| Rate for Payer: Healthscope Commercial |
$477.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.25
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.35
|
| Rate for Payer: PACE Senior Care Partners |
$126.11
|
| Rate for Payer: PACE SWMI |
$132.75
|
| Rate for Payer: PHP Commercial |
$451.35
|
| Rate for Payer: PHP Medicare Advantage |
$132.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.97
|
| Rate for Payer: Priority Health Medicare |
$132.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.86
|
| Rate for Payer: Railroad Medicare Medicare |
$132.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.28
|
| Rate for Payer: UHC Core |
$443.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.75
|
| Rate for Payer: UHC Medicare Advantage |
$136.73
|
| Rate for Payer: VA VA |
$132.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.25
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
OP
|
$200.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.55 |
| Max. Negotiated Rate |
$180.21 |
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: Aetna Medicare |
$52.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.57
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$50.06
|
| Rate for Payer: BCBS Trust/PPO |
$155.68
|
| Rate for Payer: BCN Commercial |
$155.68
|
| Rate for Payer: BCN Medicare Advantage |
$50.06
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.06
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.20
|
| Rate for Payer: PACE Senior Care Partners |
$47.55
|
| Rate for Payer: PACE SWMI |
$50.06
|
| Rate for Payer: PHP Commercial |
$170.20
|
| Rate for Payer: PHP Medicare Advantage |
$50.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.20
|
| Rate for Payer: Priority Health Medicare |
$50.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.12
|
| Rate for Payer: Railroad Medicare Medicare |
$50.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.20
|
| Rate for Payer: UHC Core |
$167.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.56
|
| Rate for Payer: VA VA |
$50.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC DEXA BONE DENSITY APPENDICULAR
|
Facility
|
IP
|
$200.23
|
|
|
Service Code
|
CPT 77081
|
| Hospital Charge Code |
32000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.12 |
| Max. Negotiated Rate |
$180.21 |
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: BCBS Trust/PPO |
$154.74
|
| Rate for Payer: BCN Commercial |
$154.74
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.20
|
| Rate for Payer: PHP Commercial |
$170.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.20
|
| Rate for Payer: UHC Core |
$167.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
IP
|
$147.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$89.95 |
| Max. Negotiated Rate |
$132.73 |
| Rate for Payer: Aetna Commercial |
$125.36
|
| Rate for Payer: BCBS Trust/PPO |
$113.97
|
| Rate for Payer: BCN Commercial |
$113.97
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$126.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.98
|
| Rate for Payer: Healthscope Commercial |
$132.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.36
|
| Rate for Payer: PHP Commercial |
$125.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.78
|
| Rate for Payer: UHC Core |
$123.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.61
|
|
|
HC DEXAMETHASONE DEXA
|
Facility
|
OP
|
$147.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$132.73 |
| Rate for Payer: Aetna Commercial |
$125.36
|
| Rate for Payer: Aetna Medicare |
$38.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.09
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$36.87
|
| Rate for Payer: BCBS Trust/PPO |
$114.67
|
| Rate for Payer: BCN Commercial |
$114.67
|
| Rate for Payer: BCN Medicare Advantage |
$36.87
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cash Price |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$126.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.87
|
| Rate for Payer: Healthscope Commercial |
$132.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.61
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.36
|
| Rate for Payer: PACE Senior Care Partners |
$35.03
|
| Rate for Payer: PACE SWMI |
$36.87
|
| Rate for Payer: PHP Commercial |
$125.36
|
| Rate for Payer: PHP Medicare Advantage |
$36.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.31
|
| Rate for Payer: Priority Health Medicare |
$36.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.95
|
| Rate for Payer: Railroad Medicare Medicare |
$36.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.78
|
| Rate for Payer: UHC Core |
$123.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.87
|
| Rate for Payer: UHC Medicare Advantage |
$37.98
|
| Rate for Payer: VA VA |
$36.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.61
|
|
|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
IP
|
$10.20
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: BCBS Trust/PPO |
$7.88
|
| Rate for Payer: BCN Commercial |
$7.88
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.98
|
| Rate for Payer: UHC Core |
$8.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
OP
|
$10.20
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna Medicare |
$2.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.19
|
| Rate for Payer: BCBS Complete |
$4.08
|
| Rate for Payer: BCBS MAPPO |
$2.55
|
| Rate for Payer: BCBS Trust/PPO |
$7.93
|
| Rate for Payer: BCN Commercial |
$7.93
|
| Rate for Payer: BCN Medicare Advantage |
$2.55
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.55
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PACE Senior Care Partners |
$2.42
|
| Rate for Payer: PACE SWMI |
$2.55
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: PHP Medicare Advantage |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$2.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.98
|
| Rate for Payer: UHC Core |
$8.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.55
|
| Rate for Payer: UHC Medicare Advantage |
$2.63
|
| Rate for Payer: VA VA |
$2.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC DHEA
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC DHEA
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.87 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$19.58
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$18.65
|
| Rate for Payer: Meridian Medicaid |
$19.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC DHEA-SULFATE
|
Facility
|
IP
|
$55.08
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.59 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: BCBS Trust/PPO |
$42.57
|
| Rate for Payer: BCN Commercial |
$42.57
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC DHEA-SULFATE
|
Facility
|
OP
|
$55.08
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.08 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.21
|
| Rate for Payer: BCBS Complete |
$17.23
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$16.41
|
| Rate for Payer: Meridian Medicaid |
$17.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PACE Senior Care Partners |
$13.08
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.92
|
| Rate for Payer: Priority Health Medicare |
$13.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.77
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: VA VA |
$13.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna Medicare |
$16.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.33
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS MAPPO |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$48.09
|
| Rate for Payer: BCN Commercial |
$48.09
|
| Rate for Payer: BCN Medicare Advantage |
$15.46
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.46
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PACE Senior Care Partners |
$14.69
|
| Rate for Payer: PACE SWMI |
$15.46
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.81
|
| Rate for Payer: Priority Health Medicare |
$15.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.46
|
| Rate for Payer: UHC Medicare Advantage |
$15.93
|
| Rate for Payer: VA VA |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$37.72 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
OP
|
$47.73
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.34 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.92
|
| Rate for Payer: BCBS Complete |
$16.59
|
| Rate for Payer: BCBS MAPPO |
$11.93
|
| Rate for Payer: BCBS Trust/PPO |
$37.11
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: BCN Medicare Advantage |
$11.93
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.93
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Mclaren Medicaid |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$16.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.57
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.93
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.53
|
| Rate for Payer: Priority Health Medicare |
$11.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: Railroad Medicare Medicare |
$11.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$39.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.93
|
| Rate for Payer: UHC Medicare Advantage |
$12.29
|
| Rate for Payer: VA VA |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
IP
|
$47.73
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.11 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$36.89
|
| Rate for Payer: BCN Commercial |
$36.89
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.57
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$39.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
IP
|
$146.83
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$89.55 |
| Max. Negotiated Rate |
$132.15 |
| Rate for Payer: Aetna Commercial |
$124.81
|
| Rate for Payer: BCBS Trust/PPO |
$113.47
|
| Rate for Payer: BCN Commercial |
$113.47
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.46
|
| Rate for Payer: Healthscope Commercial |
$132.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.81
|
| Rate for Payer: PHP Commercial |
$124.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.21
|
| Rate for Payer: UHC Core |
$122.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.12
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
OP
|
$146.83
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$132.15 |
| Rate for Payer: Aetna Commercial |
$124.81
|
| Rate for Payer: Aetna Medicare |
$38.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.88
|
| Rate for Payer: BCBS Complete |
$58.73
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCBS Trust/PPO |
$114.16
|
| Rate for Payer: BCN Commercial |
$114.16
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Healthscope Commercial |
$132.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.81
|
| Rate for Payer: PACE Senior Care Partners |
$34.87
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PHP Commercial |
$124.81
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.74
|
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.55
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.21
|
| Rate for Payer: UHC Core |
$122.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.71
|
| Rate for Payer: UHC Medicare Advantage |
$37.81
|
| Rate for Payer: VA VA |
$36.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.12
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
OP
|
$10,793.44
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,563.44 |
| Max. Negotiated Rate |
$9,714.10 |
| Rate for Payer: Aetna Commercial |
$9,174.42
|
| Rate for Payer: Aetna Medicare |
$2,806.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,372.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,372.95
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$2,698.36
|
| Rate for Payer: BCBS Trust/PPO |
$8,391.90
|
| Rate for Payer: BCN Commercial |
$8,391.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,698.36
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cofinity Commercial |
$9,282.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,634.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,698.36
|
| Rate for Payer: Healthscope Commercial |
$9,714.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,095.08
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,833.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,103.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,174.42
|
| Rate for Payer: PACE Senior Care Partners |
$2,563.44
|
| Rate for Payer: PACE SWMI |
$2,698.36
|
| Rate for Payer: PHP Commercial |
$9,174.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,698.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,555.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,390.29
|
| Rate for Payer: Priority Health Medicare |
$2,698.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,582.92
|
| Rate for Payer: Railroad Medicare Medicare |
$2,698.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,498.23
|
| Rate for Payer: UHC Core |
$9,012.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,698.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,779.31
|
| Rate for Payer: VA VA |
$2,698.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,095.08
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
IP
|
$10,793.44
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,582.92 |
| Max. Negotiated Rate |
$9,714.10 |
| Rate for Payer: Aetna Commercial |
$9,174.42
|
| Rate for Payer: BCBS Trust/PPO |
$8,341.17
|
| Rate for Payer: BCN Commercial |
$8,341.17
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cofinity Commercial |
$9,282.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,634.75
|
| Rate for Payer: Healthscope Commercial |
$9,714.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,095.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,174.42
|
| Rate for Payer: PHP Commercial |
$9,174.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,555.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,390.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,582.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,498.23
|
| Rate for Payer: UHC Core |
$9,012.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,095.08
|
|
