|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$552.65
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$359.22 |
| Max. Negotiated Rate |
$497.38 |
| Rate for Payer: Aetna Commercial |
$469.75
|
| Rate for Payer: BCBS Trust/PPO |
$451.13
|
| Rate for Payer: BCN Commercial |
$427.09
|
| Rate for Payer: Cash Price |
$442.12
|
| Rate for Payer: Cofinity Commercial |
$475.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.12
|
| Rate for Payer: Healthscope Commercial |
$497.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.75
|
| Rate for Payer: Nomi Health Commercial |
$453.17
|
| Rate for Payer: PHP Commercial |
$469.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.22
|
| Rate for Payer: Priority Health HMO/PPO |
$480.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.33
|
| Rate for Payer: UHC Core |
$461.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.49
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,231.07 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: BCBS Trust/PPO |
$5,313.57
|
| Rate for Payer: BCN Commercial |
$5,030.42
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,545.97 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$1,692.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,034.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,034.17
|
| Rate for Payer: BCBS Complete |
$4,241.07
|
| Rate for Payer: BCBS MAPPO |
$1,627.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,351.33
|
| Rate for Payer: BCN Commercial |
$5,061.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,627.34
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,627.34
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Mclaren Medicaid |
$4,038.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.70
|
| Rate for Payer: Meridian Medicaid |
$4,241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,871.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PACE Senior Care Partners |
$1,545.97
|
| Rate for Payer: PACE SWMI |
$1,627.34
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,627.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,038.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Medicare |
$1,643.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,627.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,627.34
|
| Rate for Payer: UHC Exchange |
$1,627.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,627.34
|
| Rate for Payer: UHCCP Medicaid |
$4,038.85
|
| Rate for Payer: VA VA |
$1,627.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,545.97 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$1,692.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,034.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,034.17
|
| Rate for Payer: BCBS Complete |
$4,241.07
|
| Rate for Payer: BCBS MAPPO |
$1,627.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,351.33
|
| Rate for Payer: BCN Commercial |
$5,061.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,627.34
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,627.34
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Mclaren Medicaid |
$4,038.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.70
|
| Rate for Payer: Meridian Medicaid |
$4,241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,871.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PACE Senior Care Partners |
$1,545.97
|
| Rate for Payer: PACE SWMI |
$1,627.34
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,627.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,038.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Medicare |
$1,643.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,627.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,627.34
|
| Rate for Payer: UHC Exchange |
$1,627.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,627.34
|
| Rate for Payer: UHCCP Medicaid |
$4,038.85
|
| Rate for Payer: VA VA |
$1,627.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,231.07 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: BCBS Trust/PPO |
$5,313.57
|
| Rate for Payer: BCN Commercial |
$5,030.42
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$1,011.36
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$657.38 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: BCBS Trust/PPO |
$825.57
|
| Rate for Payer: BCN Commercial |
$781.58
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: Nomi Health Commercial |
$829.32
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health HMO/PPO |
$879.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.00
|
| Rate for Payer: UHC Core |
$844.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.52
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$1,011.36
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.20 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna Medicare |
$262.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$316.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$316.05
|
| Rate for Payer: BCBS Complete |
$404.54
|
| Rate for Payer: BCBS MAPPO |
$252.84
|
| Rate for Payer: BCBS Trust/PPO |
$831.44
|
| Rate for Payer: BCN Commercial |
$786.33
|
| Rate for Payer: BCN Medicare Advantage |
$252.84
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.84
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: Nomi Health Commercial |
$829.32
|
| Rate for Payer: PACE Senior Care Partners |
$240.20
|
| Rate for Payer: PACE SWMI |
$252.84
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: PHP Medicare Advantage |
$252.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health HMO/PPO |
$879.88
|
| Rate for Payer: Priority Health Medicare |
$255.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.61
|
| Rate for Payer: Railroad Medicare Medicare |
$252.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.00
|
| Rate for Payer: UHC Core |
$844.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.84
|
| Rate for Payer: UHC Exchange |
$252.84
|
| Rate for Payer: UHC Medicare Advantage |
$252.84
|
| Rate for Payer: VA VA |
$252.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.52
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$1,011.36
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.20 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: Aetna Medicare |
$262.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$316.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$316.05
|
| Rate for Payer: BCBS Complete |
$404.54
|
| Rate for Payer: BCBS MAPPO |
$252.84
|
| Rate for Payer: BCBS Trust/PPO |
$831.44
|
| Rate for Payer: BCN Commercial |
$786.33
|
| Rate for Payer: BCN Medicare Advantage |
$252.84
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.84
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: Nomi Health Commercial |
$829.32
|
| Rate for Payer: PACE Senior Care Partners |
$240.20
|
| Rate for Payer: PACE SWMI |
$252.84
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: PHP Medicare Advantage |
$252.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health HMO/PPO |
$879.88
|
| Rate for Payer: Priority Health Medicare |
$255.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.61
|
| Rate for Payer: Railroad Medicare Medicare |
$252.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.00
|
| Rate for Payer: UHC Core |
$844.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.84
|
| Rate for Payer: UHC Exchange |
$252.84
|
| Rate for Payer: UHC Medicare Advantage |
$252.84
|
| Rate for Payer: VA VA |
$252.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.52
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$1,011.36
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$657.38 |
| Max. Negotiated Rate |
$910.22 |
| Rate for Payer: Aetna Commercial |
$859.66
|
| Rate for Payer: BCBS Trust/PPO |
$825.57
|
| Rate for Payer: BCN Commercial |
$781.58
|
| Rate for Payer: Cash Price |
$809.09
|
| Rate for Payer: Cofinity Commercial |
$869.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.09
|
| Rate for Payer: Healthscope Commercial |
$910.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.66
|
| Rate for Payer: Nomi Health Commercial |
$829.32
|
| Rate for Payer: PHP Commercial |
$859.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.38
|
| Rate for Payer: Priority Health HMO/PPO |
$879.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$890.00
|
| Rate for Payer: UHC Core |
$844.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.52
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,865.63
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,212.66 |
| Max. Negotiated Rate |
$1,679.07 |
| Rate for Payer: Aetna Commercial |
$1,585.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,522.91
|
| Rate for Payer: BCN Commercial |
$1,441.76
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cofinity Commercial |
$1,604.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,492.50
|
| Rate for Payer: Healthscope Commercial |
$1,679.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,399.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,585.79
|
| Rate for Payer: Nomi Health Commercial |
$1,529.82
|
| Rate for Payer: PHP Commercial |
$1,585.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.66
|
| Rate for Payer: Priority Health HMO/PPO |
$1,623.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,249.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,641.75
|
| Rate for Payer: UHC Core |
$1,557.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,399.22
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,865.63
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,679.07 |
| Rate for Payer: Aetna Commercial |
$1,585.79
|
| Rate for Payer: Aetna Medicare |
$485.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$583.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$583.01
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$466.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,533.73
|
| Rate for Payer: BCN Commercial |
$1,450.53
|
| Rate for Payer: BCN Medicare Advantage |
$466.41
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cash Price |
$1,492.50
|
| Rate for Payer: Cofinity Commercial |
$1,604.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,492.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.41
|
| Rate for Payer: Healthscope Commercial |
$1,679.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,399.22
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.73
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,585.79
|
| Rate for Payer: Nomi Health Commercial |
$1,529.82
|
| Rate for Payer: PACE Senior Care Partners |
$443.09
|
| Rate for Payer: PACE SWMI |
$466.41
|
| Rate for Payer: PHP Commercial |
$1,585.79
|
| Rate for Payer: PHP Medicare Advantage |
$466.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,212.66
|
| Rate for Payer: Priority Health HMO/PPO |
$1,623.10
|
| Rate for Payer: Priority Health Medicare |
$471.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,249.97
|
| Rate for Payer: Railroad Medicare Medicare |
$466.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,641.75
|
| Rate for Payer: UHC Core |
$1,557.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.41
|
| Rate for Payer: UHC Exchange |
$466.41
|
| Rate for Payer: UHC Medicare Advantage |
$466.41
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$466.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,399.22
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$28.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.79
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS MAPPO |
$27.03
|
| Rate for Payer: BCBS Trust/PPO |
$88.89
|
| Rate for Payer: BCN Commercial |
$84.06
|
| Rate for Payer: BCN Medicare Advantage |
$27.03
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.03
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$10.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.38
|
| Rate for Payer: Meridian Medicaid |
$11.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PACE Senior Care Partners |
$25.68
|
| Rate for Payer: PACE SWMI |
$27.03
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$27.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Medicare |
$27.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: Railroad Medicare Medicare |
$27.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.03
|
| Rate for Payer: UHC Exchange |
$27.03
|
| Rate for Payer: UHC Medicare Advantage |
$27.03
|
| Rate for Payer: UHCCP Medicaid |
$10.56
|
| Rate for Payer: VA VA |
$27.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.28 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: BCBS Trust/PPO |
$88.26
|
| Rate for Payer: BCN Commercial |
$83.56
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$28.31
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$10.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$11.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.10
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$10.56
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC ANGIOTENSIN II
|
Facility
|
OP
|
$331.50
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.84 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Aetna Commercial |
$281.78
|
| Rate for Payer: Aetna Medicare |
$86.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.59
|
| Rate for Payer: BCBS Complete |
$15.58
|
| Rate for Payer: BCBS MAPPO |
$82.88
|
| Rate for Payer: BCBS Trust/PPO |
$272.53
|
| Rate for Payer: BCN Commercial |
$257.74
|
| Rate for Payer: BCN Medicare Advantage |
$82.88
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cofinity Commercial |
$285.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$298.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.62
|
| Rate for Payer: Mclaren Medicaid |
$14.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.02
|
| Rate for Payer: Meridian Medicaid |
$15.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.78
|
| Rate for Payer: Nomi Health Commercial |
$271.83
|
| Rate for Payer: PACE Senior Care Partners |
$78.73
|
| Rate for Payer: PACE SWMI |
$82.88
|
| Rate for Payer: PHP Commercial |
$281.78
|
| Rate for Payer: PHP Medicare Advantage |
$82.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.48
|
| Rate for Payer: Priority Health HMO/PPO |
$288.40
|
| Rate for Payer: Priority Health Medicare |
$83.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.10
|
| Rate for Payer: Railroad Medicare Medicare |
$82.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.72
|
| Rate for Payer: UHC Core |
$276.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.88
|
| Rate for Payer: UHC Exchange |
$82.88
|
| Rate for Payer: UHC Medicare Advantage |
$82.88
|
| Rate for Payer: UHCCP Medicaid |
$14.84
|
| Rate for Payer: VA VA |
$82.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.62
|
|
|
HC ANGIOTENSIN II
|
Facility
|
IP
|
$331.50
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$215.48 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Aetna Commercial |
$281.78
|
| Rate for Payer: BCBS Trust/PPO |
$270.60
|
| Rate for Payer: BCN Commercial |
$256.18
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cofinity Commercial |
$285.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.20
|
| Rate for Payer: Healthscope Commercial |
$298.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.78
|
| Rate for Payer: Nomi Health Commercial |
$271.83
|
| Rate for Payer: PHP Commercial |
$281.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.48
|
| Rate for Payer: Priority Health HMO/PPO |
$288.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.72
|
| Rate for Payer: UHC Core |
$276.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.62
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
OP
|
$66.79
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.86 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$56.77
|
| Rate for Payer: Aetna Medicare |
$17.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.87
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$16.70
|
| Rate for Payer: BCBS Trust/PPO |
$54.91
|
| Rate for Payer: BCN Commercial |
$51.93
|
| Rate for Payer: BCN Medicare Advantage |
$16.70
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cofinity Commercial |
$57.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.70
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Mclaren Medicaid |
$27.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.53
|
| Rate for Payer: Meridian Medicaid |
$29.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.77
|
| Rate for Payer: Nomi Health Commercial |
$54.77
|
| Rate for Payer: PACE Senior Care Partners |
$15.86
|
| Rate for Payer: PACE SWMI |
$16.70
|
| Rate for Payer: PHP Commercial |
$56.77
|
| Rate for Payer: PHP Medicare Advantage |
$16.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health HMO/PPO |
$58.11
|
| Rate for Payer: Priority Health Medicare |
$16.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.75
|
| Rate for Payer: Railroad Medicare Medicare |
$16.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.78
|
| Rate for Payer: UHC Core |
$55.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.70
|
| Rate for Payer: UHC Exchange |
$16.70
|
| Rate for Payer: UHC Medicare Advantage |
$16.70
|
| Rate for Payer: UHCCP Medicaid |
$27.81
|
| Rate for Payer: VA VA |
$16.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$66.79
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.41 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna Commercial |
$56.77
|
| Rate for Payer: BCBS Trust/PPO |
$54.52
|
| Rate for Payer: BCN Commercial |
$51.62
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cofinity Commercial |
$57.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.43
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.77
|
| Rate for Payer: Nomi Health Commercial |
$54.77
|
| Rate for Payer: PHP Commercial |
$56.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.41
|
| Rate for Payer: Priority Health HMO/PPO |
$58.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.78
|
| Rate for Payer: UHC Core |
$55.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
OP
|
$33.41
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$30.07 |
| Rate for Payer: Aetna Commercial |
$28.40
|
| Rate for Payer: Aetna Medicare |
$8.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.44
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$8.35
|
| Rate for Payer: BCBS Trust/PPO |
$27.47
|
| Rate for Payer: BCN Commercial |
$25.98
|
| Rate for Payer: BCN Medicare Advantage |
$8.35
|
| Rate for Payer: Cash Price |
$26.73
|
| Rate for Payer: Cofinity Commercial |
$28.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.35
|
| Rate for Payer: Healthscope Commercial |
$30.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$27.40
|
| Rate for Payer: PACE Senior Care Partners |
$7.93
|
| Rate for Payer: PACE SWMI |
$8.35
|
| Rate for Payer: PHP Commercial |
$28.40
|
| Rate for Payer: PHP Medicare Advantage |
$8.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.72
|
| Rate for Payer: Priority Health HMO/PPO |
$29.07
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.38
|
| Rate for Payer: Railroad Medicare Medicare |
$8.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.40
|
| Rate for Payer: UHC Core |
$27.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.35
|
| Rate for Payer: UHC Exchange |
$8.35
|
| Rate for Payer: UHC Medicare Advantage |
$8.35
|
| Rate for Payer: VA VA |
$8.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.06
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
IP
|
$33.41
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$30.07 |
| Rate for Payer: Aetna Commercial |
$28.40
|
| Rate for Payer: BCBS Trust/PPO |
$27.27
|
| Rate for Payer: BCN Commercial |
$25.82
|
| Rate for Payer: Cash Price |
$26.73
|
| Rate for Payer: Cofinity Commercial |
$28.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.73
|
| Rate for Payer: Healthscope Commercial |
$30.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$27.40
|
| Rate for Payer: PHP Commercial |
$28.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.72
|
| Rate for Payer: Priority Health HMO/PPO |
$29.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.40
|
| Rate for Payer: UHC Core |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.06
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.12 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: Aetna Medicare |
$132.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.38
|
| Rate for Payer: BCBS Complete |
$149.64
|
| Rate for Payer: BCBS MAPPO |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$419.27
|
| Rate for Payer: BCN Commercial |
$396.52
|
| Rate for Payer: BCN Medicare Advantage |
$127.50
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.50
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Mclaren Medicaid |
$142.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.88
|
| Rate for Payer: Meridian Medicaid |
$149.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.50
|
| Rate for Payer: Nomi Health Commercial |
$418.20
|
| Rate for Payer: PACE Senior Care Partners |
$121.12
|
| Rate for Payer: PACE SWMI |
$127.50
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: PHP Medicare Advantage |
$127.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO |
$443.70
|
| Rate for Payer: Priority Health Medicare |
$128.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.70
|
| Rate for Payer: Railroad Medicare Medicare |
$127.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.50
|
| Rate for Payer: UHC Exchange |
$127.50
|
| Rate for Payer: UHC Medicare Advantage |
$127.50
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: VA VA |
$127.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$331.50 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: BCBS Trust/PPO |
$416.31
|
| Rate for Payer: BCN Commercial |
$394.13
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.50
|
| Rate for Payer: Nomi Health Commercial |
$418.20
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO |
$443.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$1,040.62
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$247.15 |
| Max. Negotiated Rate |
$936.56 |
| Rate for Payer: Aetna Commercial |
$884.53
|
| Rate for Payer: Aetna Medicare |
$270.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.19
|
| Rate for Payer: BCBS Complete |
$416.25
|
| Rate for Payer: BCBS MAPPO |
$260.16
|
| Rate for Payer: BCBS Trust/PPO |
$855.49
|
| Rate for Payer: BCN Commercial |
$809.08
|
| Rate for Payer: BCN Medicare Advantage |
$260.16
|
| Rate for Payer: Cash Price |
$832.50
|
| Rate for Payer: Cofinity Commercial |
$894.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.16
|
| Rate for Payer: Healthscope Commercial |
$936.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.53
|
| Rate for Payer: Nomi Health Commercial |
$853.31
|
| Rate for Payer: PACE Senior Care Partners |
$247.15
|
| Rate for Payer: PACE SWMI |
$260.16
|
| Rate for Payer: PHP Commercial |
$884.53
|
| Rate for Payer: PHP Medicare Advantage |
$260.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.40
|
| Rate for Payer: Priority Health HMO/PPO |
$905.34
|
| Rate for Payer: Priority Health Medicare |
$262.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$697.22
|
| Rate for Payer: Railroad Medicare Medicare |
$260.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.75
|
| Rate for Payer: UHC Core |
$868.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.16
|
| Rate for Payer: UHC Exchange |
$260.16
|
| Rate for Payer: UHC Medicare Advantage |
$260.16
|
| Rate for Payer: VA VA |
$260.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.46
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$1,040.62
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$676.40 |
| Max. Negotiated Rate |
$936.56 |
| Rate for Payer: Aetna Commercial |
$884.53
|
| Rate for Payer: BCBS Trust/PPO |
$849.46
|
| Rate for Payer: BCN Commercial |
$804.19
|
| Rate for Payer: Cash Price |
$832.50
|
| Rate for Payer: Cofinity Commercial |
$894.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.50
|
| Rate for Payer: Healthscope Commercial |
$936.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.53
|
| Rate for Payer: Nomi Health Commercial |
$853.31
|
| Rate for Payer: PHP Commercial |
$884.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.40
|
| Rate for Payer: Priority Health HMO/PPO |
$905.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$697.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.75
|
| Rate for Payer: UHC Core |
$868.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.46
|
|
