|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$2,104.04
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$499.71 |
| Max. Negotiated Rate |
$1,893.64 |
| Rate for Payer: Aetna Commercial |
$1,788.43
|
| Rate for Payer: Aetna Medicare |
$547.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.51
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$526.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.89
|
| Rate for Payer: BCN Commercial |
$1,635.89
|
| Rate for Payer: BCN Medicare Advantage |
$526.01
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cofinity Commercial |
$1,809.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.01
|
| Rate for Payer: Healthscope Commercial |
$1,893.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.03
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$604.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.43
|
| Rate for Payer: PACE Senior Care Partners |
$499.71
|
| Rate for Payer: PACE SWMI |
$526.01
|
| Rate for Payer: PHP Commercial |
$1,788.43
|
| Rate for Payer: PHP Medicare Advantage |
$526.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.51
|
| Rate for Payer: Priority Health Medicare |
$526.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.25
|
| Rate for Payer: Railroad Medicare Medicare |
$526.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.56
|
| Rate for Payer: UHC Core |
$1,756.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.01
|
| Rate for Payer: UHC Medicare Advantage |
$541.79
|
| Rate for Payer: VA VA |
$526.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.03
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$2,104.04
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,283.25 |
| Max. Negotiated Rate |
$1,893.64 |
| Rate for Payer: Aetna Commercial |
$1,788.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.00
|
| Rate for Payer: BCN Commercial |
$1,626.00
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cofinity Commercial |
$1,809.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.23
|
| Rate for Payer: Healthscope Commercial |
$1,893.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.43
|
| Rate for Payer: PHP Commercial |
$1,788.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.56
|
| Rate for Payer: UHC Core |
$1,756.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.03
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
OP
|
$18,171.61
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,315.76 |
| Max. Negotiated Rate |
$16,354.45 |
| Rate for Payer: Aetna Commercial |
$15,445.87
|
| Rate for Payer: Aetna Medicare |
$4,724.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,678.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,678.63
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$4,542.90
|
| Rate for Payer: BCBS Trust/PPO |
$14,128.43
|
| Rate for Payer: BCN Commercial |
$14,128.43
|
| Rate for Payer: BCN Medicare Advantage |
$4,542.90
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cofinity Commercial |
$15,627.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,537.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,542.90
|
| Rate for Payer: Healthscope Commercial |
$16,354.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,628.71
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,770.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,224.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,445.87
|
| Rate for Payer: PACE Senior Care Partners |
$4,315.76
|
| Rate for Payer: PACE SWMI |
$4,542.90
|
| Rate for Payer: PHP Commercial |
$15,445.87
|
| Rate for Payer: PHP Medicare Advantage |
$4,542.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,720.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,809.30
|
| Rate for Payer: Priority Health Medicare |
$4,542.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,082.86
|
| Rate for Payer: Railroad Medicare Medicare |
$4,542.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,991.02
|
| Rate for Payer: UHC Core |
$15,173.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,542.90
|
| Rate for Payer: UHC Medicare Advantage |
$4,679.19
|
| Rate for Payer: VA VA |
$4,542.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,628.71
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
IP
|
$18,171.61
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,082.86 |
| Max. Negotiated Rate |
$16,354.45 |
| Rate for Payer: Aetna Commercial |
$15,445.87
|
| Rate for Payer: BCBS Trust/PPO |
$14,043.02
|
| Rate for Payer: BCN Commercial |
$14,043.02
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cofinity Commercial |
$15,627.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,537.29
|
| Rate for Payer: Healthscope Commercial |
$16,354.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,628.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,445.87
|
| Rate for Payer: PHP Commercial |
$15,445.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,720.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,809.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,082.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,991.02
|
| Rate for Payer: UHC Core |
$15,173.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,628.71
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
OP
|
$1,026.90
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.89 |
| Max. Negotiated Rate |
$924.21 |
| Rate for Payer: Aetna Commercial |
$872.86
|
| Rate for Payer: Aetna Medicare |
$266.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.91
|
| Rate for Payer: BCBS Complete |
$410.76
|
| Rate for Payer: BCBS MAPPO |
$256.72
|
| Rate for Payer: BCBS Trust/PPO |
$798.41
|
| Rate for Payer: BCN Commercial |
$798.41
|
| Rate for Payer: BCN Medicare Advantage |
$256.72
|
| Rate for Payer: Cash Price |
$821.52
|
| Rate for Payer: Cofinity Commercial |
$883.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.72
|
| Rate for Payer: Healthscope Commercial |
$924.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$269.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$295.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$872.86
|
| Rate for Payer: PACE Senior Care Partners |
$243.89
|
| Rate for Payer: PACE SWMI |
$256.72
|
| Rate for Payer: PHP Commercial |
$872.86
|
| Rate for Payer: PHP Medicare Advantage |
$256.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.40
|
| Rate for Payer: Priority Health Medicare |
$256.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.31
|
| Rate for Payer: Railroad Medicare Medicare |
$256.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.67
|
| Rate for Payer: UHC Core |
$857.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.72
|
| Rate for Payer: UHC Medicare Advantage |
$264.43
|
| Rate for Payer: VA VA |
$256.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.18
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
IP
|
$1,026.90
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$626.31 |
| Max. Negotiated Rate |
$924.21 |
| Rate for Payer: Aetna Commercial |
$872.86
|
| Rate for Payer: BCBS Trust/PPO |
$793.59
|
| Rate for Payer: BCN Commercial |
$793.59
|
| Rate for Payer: Cash Price |
$821.52
|
| Rate for Payer: Cofinity Commercial |
$883.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.52
|
| Rate for Payer: Healthscope Commercial |
$924.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$872.86
|
| Rate for Payer: PHP Commercial |
$872.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$893.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.67
|
| Rate for Payer: UHC Core |
$857.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.18
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
OP
|
$1,148.99
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$272.89 |
| Max. Negotiated Rate |
$1,034.09 |
| Rate for Payer: Aetna Commercial |
$976.64
|
| Rate for Payer: Aetna Medicare |
$298.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.06
|
| Rate for Payer: BCBS Complete |
$459.60
|
| Rate for Payer: BCBS MAPPO |
$287.25
|
| Rate for Payer: BCBS Trust/PPO |
$893.34
|
| Rate for Payer: BCN Commercial |
$893.34
|
| Rate for Payer: BCN Medicare Advantage |
$287.25
|
| Rate for Payer: Cash Price |
$919.19
|
| Rate for Payer: Cofinity Commercial |
$988.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.25
|
| Rate for Payer: Healthscope Commercial |
$1,034.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$301.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$330.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$976.64
|
| Rate for Payer: PACE Senior Care Partners |
$272.89
|
| Rate for Payer: PACE SWMI |
$287.25
|
| Rate for Payer: PHP Commercial |
$976.64
|
| Rate for Payer: PHP Medicare Advantage |
$287.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$999.62
|
| Rate for Payer: Priority Health Medicare |
$287.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$700.77
|
| Rate for Payer: Railroad Medicare Medicare |
$287.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,011.11
|
| Rate for Payer: UHC Core |
$959.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.25
|
| Rate for Payer: UHC Medicare Advantage |
$295.86
|
| Rate for Payer: VA VA |
$287.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.74
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
IP
|
$1,148.99
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$700.77 |
| Max. Negotiated Rate |
$1,034.09 |
| Rate for Payer: Aetna Commercial |
$976.64
|
| Rate for Payer: BCBS Trust/PPO |
$887.94
|
| Rate for Payer: BCN Commercial |
$887.94
|
| Rate for Payer: Cash Price |
$919.19
|
| Rate for Payer: Cofinity Commercial |
$988.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.19
|
| Rate for Payer: Healthscope Commercial |
$1,034.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$976.64
|
| Rate for Payer: PHP Commercial |
$976.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$999.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$700.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,011.11
|
| Rate for Payer: UHC Core |
$959.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.74
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
OP
|
$1,353.00
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.34 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Aetna Commercial |
$1,150.05
|
| Rate for Payer: Aetna Medicare |
$351.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$422.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$422.81
|
| Rate for Payer: BCBS Complete |
$541.20
|
| Rate for Payer: BCBS MAPPO |
$338.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,051.96
|
| Rate for Payer: BCN Commercial |
$1,051.96
|
| Rate for Payer: BCN Medicare Advantage |
$338.25
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.25
|
| Rate for Payer: Healthscope Commercial |
$1,217.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$355.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$388.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,150.05
|
| Rate for Payer: PACE Senior Care Partners |
$321.34
|
| Rate for Payer: PACE SWMI |
$338.25
|
| Rate for Payer: PHP Commercial |
$1,150.05
|
| Rate for Payer: PHP Medicare Advantage |
$338.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,177.11
|
| Rate for Payer: Priority Health Medicare |
$338.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.19
|
| Rate for Payer: Railroad Medicare Medicare |
$338.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.64
|
| Rate for Payer: UHC Core |
$1,129.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.25
|
| Rate for Payer: UHC Medicare Advantage |
$348.40
|
| Rate for Payer: VA VA |
$338.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.75
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
IP
|
$1,353.00
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.19 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Aetna Commercial |
$1,150.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,045.60
|
| Rate for Payer: BCN Commercial |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.40
|
| Rate for Payer: Healthscope Commercial |
$1,217.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,150.05
|
| Rate for Payer: PHP Commercial |
$1,150.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,177.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.64
|
| Rate for Payer: UHC Core |
$1,129.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.75
|
|
|
HC DIALYSIS CATH LVL 2 SHORT TERM
|
Facility
|
IP
|
$203.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.41 |
| Max. Negotiated Rate |
$183.59 |
| Rate for Payer: Aetna Commercial |
$173.39
|
| Rate for Payer: BCBS Trust/PPO |
$157.64
|
| Rate for Payer: BCN Commercial |
$157.64
|
| Rate for Payer: Cash Price |
$163.19
|
| Rate for Payer: Cofinity Commercial |
$175.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.19
|
| Rate for Payer: Healthscope Commercial |
$183.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.39
|
| Rate for Payer: PHP Commercial |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.51
|
| Rate for Payer: UHC Core |
$170.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.99
|
|
|
HC DIALYSIS CATH LVL 2 SHORT TERM
|
Facility
|
OP
|
$203.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$183.59 |
| Rate for Payer: Aetna Commercial |
$173.39
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.75
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$158.60
|
| Rate for Payer: BCN Commercial |
$158.60
|
| Rate for Payer: BCN Medicare Advantage |
$51.00
|
| Rate for Payer: Cash Price |
$163.19
|
| Rate for Payer: Cofinity Commercial |
$175.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.00
|
| Rate for Payer: Healthscope Commercial |
$183.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.39
|
| Rate for Payer: PACE Senior Care Partners |
$48.45
|
| Rate for Payer: PACE SWMI |
$51.00
|
| Rate for Payer: PHP Commercial |
$173.39
|
| Rate for Payer: PHP Medicare Advantage |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.47
|
| Rate for Payer: Priority Health Medicare |
$51.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.41
|
| Rate for Payer: Railroad Medicare Medicare |
$51.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.51
|
| Rate for Payer: UHC Core |
$170.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.00
|
| Rate for Payer: UHC Medicare Advantage |
$52.53
|
| Rate for Payer: VA VA |
$51.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.99
|
|
|
HC DIALYSIS CATH LVL 3 SHORT TERM
|
Facility
|
OP
|
$308.99
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
27200317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.39 |
| Max. Negotiated Rate |
$278.09 |
| Rate for Payer: Aetna Commercial |
$262.64
|
| Rate for Payer: Aetna Medicare |
$80.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.56
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS MAPPO |
$77.25
|
| Rate for Payer: BCBS Trust/PPO |
$240.24
|
| Rate for Payer: BCN Commercial |
$240.24
|
| Rate for Payer: BCN Medicare Advantage |
$77.25
|
| Rate for Payer: Cash Price |
$247.19
|
| Rate for Payer: Cofinity Commercial |
$265.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.25
|
| Rate for Payer: Healthscope Commercial |
$278.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.64
|
| Rate for Payer: PACE Senior Care Partners |
$73.39
|
| Rate for Payer: PACE SWMI |
$77.25
|
| Rate for Payer: PHP Commercial |
$262.64
|
| Rate for Payer: PHP Medicare Advantage |
$77.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.82
|
| Rate for Payer: Priority Health Medicare |
$77.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.45
|
| Rate for Payer: Railroad Medicare Medicare |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.91
|
| Rate for Payer: UHC Core |
$258.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.25
|
| Rate for Payer: UHC Medicare Advantage |
$79.56
|
| Rate for Payer: VA VA |
$77.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.74
|
|
|
HC DIALYSIS CATH LVL 3 SHORT TERM
|
Facility
|
IP
|
$308.99
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
27200317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.45 |
| Max. Negotiated Rate |
$278.09 |
| Rate for Payer: Aetna Commercial |
$262.64
|
| Rate for Payer: BCBS Trust/PPO |
$238.79
|
| Rate for Payer: BCN Commercial |
$238.79
|
| Rate for Payer: Cash Price |
$247.19
|
| Rate for Payer: Cofinity Commercial |
$265.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.19
|
| Rate for Payer: Healthscope Commercial |
$278.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.64
|
| Rate for Payer: PHP Commercial |
$262.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.91
|
| Rate for Payer: UHC Core |
$258.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.74
|
|
|
HC DIALYSIS CATH LVL 4 SHORT TERM
|
Facility
|
OP
|
$413.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.32 |
| Max. Negotiated Rate |
$372.59 |
| Rate for Payer: Aetna Commercial |
$351.89
|
| Rate for Payer: Aetna Medicare |
$107.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.37
|
| Rate for Payer: BCBS Complete |
$165.60
|
| Rate for Payer: BCBS MAPPO |
$103.50
|
| Rate for Payer: BCBS Trust/PPO |
$321.88
|
| Rate for Payer: BCN Commercial |
$321.88
|
| Rate for Payer: BCN Medicare Advantage |
$103.50
|
| Rate for Payer: Cash Price |
$331.19
|
| Rate for Payer: Cofinity Commercial |
$356.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.50
|
| Rate for Payer: Healthscope Commercial |
$372.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.89
|
| Rate for Payer: PACE Senior Care Partners |
$98.32
|
| Rate for Payer: PACE SWMI |
$103.50
|
| Rate for Payer: PHP Commercial |
$351.89
|
| Rate for Payer: PHP Medicare Advantage |
$103.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.17
|
| Rate for Payer: Priority Health Medicare |
$103.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.49
|
| Rate for Payer: Railroad Medicare Medicare |
$103.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.31
|
| Rate for Payer: UHC Core |
$345.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.50
|
| Rate for Payer: UHC Medicare Advantage |
$106.60
|
| Rate for Payer: VA VA |
$103.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.49
|
|
|
HC DIALYSIS CATH LVL 4 SHORT TERM
|
Facility
|
IP
|
$413.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$252.49 |
| Max. Negotiated Rate |
$372.59 |
| Rate for Payer: Aetna Commercial |
$351.89
|
| Rate for Payer: BCBS Trust/PPO |
$319.93
|
| Rate for Payer: BCN Commercial |
$319.93
|
| Rate for Payer: Cash Price |
$331.19
|
| Rate for Payer: Cofinity Commercial |
$356.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.19
|
| Rate for Payer: Healthscope Commercial |
$372.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.89
|
| Rate for Payer: PHP Commercial |
$351.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$360.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.31
|
| Rate for Payer: UHC Core |
$345.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.49
|
|
|
HC DIALYSIS CATH LVL 5 SHORT TERM
|
Facility
|
OP
|
$518.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.26 |
| Max. Negotiated Rate |
$467.09 |
| Rate for Payer: Aetna Commercial |
$441.14
|
| Rate for Payer: Aetna Medicare |
$134.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.18
|
| Rate for Payer: BCBS Complete |
$207.60
|
| Rate for Payer: BCBS MAPPO |
$129.75
|
| Rate for Payer: BCBS Trust/PPO |
$403.51
|
| Rate for Payer: BCN Commercial |
$403.51
|
| Rate for Payer: BCN Medicare Advantage |
$129.75
|
| Rate for Payer: Cash Price |
$415.19
|
| Rate for Payer: Cofinity Commercial |
$446.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.75
|
| Rate for Payer: Healthscope Commercial |
$467.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.14
|
| Rate for Payer: PACE Senior Care Partners |
$123.26
|
| Rate for Payer: PACE SWMI |
$129.75
|
| Rate for Payer: PHP Commercial |
$441.14
|
| Rate for Payer: PHP Medicare Advantage |
$129.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.52
|
| Rate for Payer: Priority Health Medicare |
$129.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.53
|
| Rate for Payer: Railroad Medicare Medicare |
$129.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.71
|
| Rate for Payer: UHC Core |
$433.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.75
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
| Rate for Payer: VA VA |
$129.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.24
|
|
|
HC DIALYSIS CATH LVL 5 SHORT TERM
|
Facility
|
IP
|
$518.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$316.53 |
| Max. Negotiated Rate |
$467.09 |
| Rate for Payer: Aetna Commercial |
$441.14
|
| Rate for Payer: BCBS Trust/PPO |
$401.08
|
| Rate for Payer: BCN Commercial |
$401.08
|
| Rate for Payer: Cash Price |
$415.19
|
| Rate for Payer: Cofinity Commercial |
$446.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.19
|
| Rate for Payer: Healthscope Commercial |
$467.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.14
|
| Rate for Payer: PHP Commercial |
$441.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$451.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$316.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.71
|
| Rate for Payer: UHC Core |
$433.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.24
|
|
|
HC DIALYSIS CATH LVL 7 LONG TERM
|
Facility
|
IP
|
$728.99
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
27200319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$444.61 |
| Max. Negotiated Rate |
$656.09 |
| Rate for Payer: Aetna Commercial |
$619.64
|
| Rate for Payer: BCBS Trust/PPO |
$563.36
|
| Rate for Payer: BCN Commercial |
$563.36
|
| Rate for Payer: Cash Price |
$583.19
|
| Rate for Payer: Cofinity Commercial |
$626.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.19
|
| Rate for Payer: Healthscope Commercial |
$656.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$619.64
|
| Rate for Payer: PHP Commercial |
$619.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.51
|
| Rate for Payer: UHC Core |
$608.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.74
|
|
|
HC DIALYSIS CATH LVL 7 LONG TERM
|
Facility
|
OP
|
$728.99
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
27200319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.14 |
| Max. Negotiated Rate |
$656.09 |
| Rate for Payer: Aetna Commercial |
$619.64
|
| Rate for Payer: Aetna Medicare |
$189.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.81
|
| Rate for Payer: BCBS Complete |
$291.60
|
| Rate for Payer: BCBS MAPPO |
$182.25
|
| Rate for Payer: BCBS Trust/PPO |
$566.79
|
| Rate for Payer: BCN Commercial |
$566.79
|
| Rate for Payer: BCN Medicare Advantage |
$182.25
|
| Rate for Payer: Cash Price |
$583.19
|
| Rate for Payer: Cofinity Commercial |
$626.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.25
|
| Rate for Payer: Healthscope Commercial |
$656.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$191.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$619.64
|
| Rate for Payer: PACE Senior Care Partners |
$173.14
|
| Rate for Payer: PACE SWMI |
$182.25
|
| Rate for Payer: PHP Commercial |
$619.64
|
| Rate for Payer: PHP Medicare Advantage |
$182.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$634.22
|
| Rate for Payer: Priority Health Medicare |
$182.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.61
|
| Rate for Payer: Railroad Medicare Medicare |
$182.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.51
|
| Rate for Payer: UHC Core |
$608.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.25
|
| Rate for Payer: UHC Medicare Advantage |
$187.71
|
| Rate for Payer: VA VA |
$182.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.74
|
|
|
HC DIALYSIS CATH LVL 7 SHORT TERM
|
Facility
|
IP
|
$777.75
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
27200347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$474.35 |
| Max. Negotiated Rate |
$699.98 |
| Rate for Payer: Aetna Commercial |
$661.09
|
| Rate for Payer: BCBS Trust/PPO |
$601.05
|
| Rate for Payer: BCN Commercial |
$601.05
|
| Rate for Payer: Cash Price |
$622.20
|
| Rate for Payer: Cofinity Commercial |
$668.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.20
|
| Rate for Payer: Healthscope Commercial |
$699.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$661.09
|
| Rate for Payer: PHP Commercial |
$661.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.42
|
| Rate for Payer: UHC Core |
$649.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.31
|
|
|
HC DIALYSIS CATH LVL 7 SHORT TERM
|
Facility
|
OP
|
$777.75
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
27200347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.72 |
| Max. Negotiated Rate |
$699.98 |
| Rate for Payer: Aetna Commercial |
$661.09
|
| Rate for Payer: Aetna Medicare |
$202.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.05
|
| Rate for Payer: BCBS Complete |
$311.10
|
| Rate for Payer: BCBS MAPPO |
$194.44
|
| Rate for Payer: BCBS Trust/PPO |
$604.70
|
| Rate for Payer: BCN Commercial |
$604.70
|
| Rate for Payer: BCN Medicare Advantage |
$194.44
|
| Rate for Payer: Cash Price |
$622.20
|
| Rate for Payer: Cofinity Commercial |
$668.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.44
|
| Rate for Payer: Healthscope Commercial |
$699.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$661.09
|
| Rate for Payer: PACE Senior Care Partners |
$184.72
|
| Rate for Payer: PACE SWMI |
$194.44
|
| Rate for Payer: PHP Commercial |
$661.09
|
| Rate for Payer: PHP Medicare Advantage |
$194.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.64
|
| Rate for Payer: Priority Health Medicare |
$194.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.35
|
| Rate for Payer: Railroad Medicare Medicare |
$194.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.42
|
| Rate for Payer: UHC Core |
$649.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.44
|
| Rate for Payer: UHC Medicare Advantage |
$200.27
|
| Rate for Payer: VA VA |
$194.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.31
|
|
|
HC DIALYSIS CATH LVL 8 SHORT TERM
|
Facility
|
OP
|
$833.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$198.07 |
| Max. Negotiated Rate |
$750.59 |
| Rate for Payer: Aetna Commercial |
$708.89
|
| Rate for Payer: Aetna Medicare |
$216.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.62
|
| Rate for Payer: BCBS Complete |
$333.60
|
| Rate for Payer: BCBS MAPPO |
$208.50
|
| Rate for Payer: BCBS Trust/PPO |
$648.43
|
| Rate for Payer: BCN Commercial |
$648.43
|
| Rate for Payer: BCN Medicare Advantage |
$208.50
|
| Rate for Payer: Cash Price |
$667.19
|
| Rate for Payer: Cofinity Commercial |
$717.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.50
|
| Rate for Payer: Healthscope Commercial |
$750.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.89
|
| Rate for Payer: PACE Senior Care Partners |
$198.07
|
| Rate for Payer: PACE SWMI |
$208.50
|
| Rate for Payer: PHP Commercial |
$708.89
|
| Rate for Payer: PHP Medicare Advantage |
$208.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.57
|
| Rate for Payer: Priority Health Medicare |
$208.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.65
|
| Rate for Payer: Railroad Medicare Medicare |
$208.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.91
|
| Rate for Payer: UHC Core |
$696.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.50
|
| Rate for Payer: UHC Medicare Advantage |
$214.75
|
| Rate for Payer: VA VA |
$208.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.49
|
|
|
HC DIALYSIS CATH LVL 8 SHORT TERM
|
Facility
|
IP
|
$833.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200175
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$508.65 |
| Max. Negotiated Rate |
$750.59 |
| Rate for Payer: Aetna Commercial |
$708.89
|
| Rate for Payer: BCBS Trust/PPO |
$644.51
|
| Rate for Payer: BCN Commercial |
$644.51
|
| Rate for Payer: Cash Price |
$667.19
|
| Rate for Payer: Cofinity Commercial |
$717.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.19
|
| Rate for Payer: Healthscope Commercial |
$750.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$708.89
|
| Rate for Payer: PHP Commercial |
$708.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$583.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$725.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.91
|
| Rate for Payer: UHC Core |
$696.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.49
|
|
|
HC DIALYSIS CATH LVL 9 LONG TERM
|
Facility
|
IP
|
$938.99
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$572.69 |
| Max. Negotiated Rate |
$845.09 |
| Rate for Payer: Aetna Commercial |
$798.14
|
| Rate for Payer: BCBS Trust/PPO |
$725.65
|
| Rate for Payer: BCN Commercial |
$725.65
|
| Rate for Payer: Cash Price |
$751.19
|
| Rate for Payer: Cofinity Commercial |
$807.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.19
|
| Rate for Payer: Healthscope Commercial |
$845.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$798.14
|
| Rate for Payer: PHP Commercial |
$798.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$572.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$826.31
|
| Rate for Payer: UHC Core |
$784.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.24
|
|
