|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$16.89
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.98 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: BCBS Trust/PPO |
$13.79
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: Cash Price |
$13.51
|
| Rate for Payer: Cofinity Commercial |
$14.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.51
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.36
|
| Rate for Payer: Nomi Health Commercial |
$13.85
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.98
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.86
|
| Rate for Payer: UHC Core |
$14.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.67
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$22.23
|
| Rate for Payer: BCBS MAPPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$21.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$22.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.53
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Medicare |
$13.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: Railroad Medicare Medicare |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.53
|
| Rate for Payer: UHC Exchange |
$13.53
|
| Rate for Payer: UHC Medicare Advantage |
$13.53
|
| Rate for Payer: UHCCP Medicaid |
$21.17
|
| Rate for Payer: VA VA |
$13.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: BCBS Trust/PPO |
$44.16
|
| Rate for Payer: BCN Commercial |
$41.81
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.17 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$26.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$22.23
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$83.02
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.73
|
| Rate for Payer: Mclaren Medicaid |
$21.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: Meridian Medicaid |
$22.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.83
|
| Rate for Payer: Nomi Health Commercial |
$82.80
|
| Rate for Payer: PACE Senior Care Partners |
$23.98
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.64
|
| Rate for Payer: Priority Health HMO/PPO |
$87.85
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.66
|
| Rate for Payer: Railroad Medicare Medicare |
$25.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.25
|
| Rate for Payer: UHC Exchange |
$25.25
|
| Rate for Payer: UHC Medicare Advantage |
$25.25
|
| Rate for Payer: UHCCP Medicaid |
$21.17
|
| Rate for Payer: VA VA |
$25.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.73
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$65.64 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: BCBS Trust/PPO |
$82.43
|
| Rate for Payer: BCN Commercial |
$78.04
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.83
|
| Rate for Payer: Nomi Health Commercial |
$82.80
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.64
|
| Rate for Payer: Priority Health HMO/PPO |
$87.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.86
|
| Rate for Payer: UHC Core |
$84.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.73
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$435.40
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$103.41 |
| Max. Negotiated Rate |
$391.86 |
| Rate for Payer: Aetna Commercial |
$370.09
|
| Rate for Payer: Aetna Medicare |
$113.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.06
|
| Rate for Payer: BCBS Complete |
$174.16
|
| Rate for Payer: BCBS MAPPO |
$108.85
|
| Rate for Payer: BCBS Trust/PPO |
$357.94
|
| Rate for Payer: BCN Commercial |
$338.52
|
| Rate for Payer: BCN Medicare Advantage |
$108.85
|
| Rate for Payer: Cash Price |
$348.32
|
| Rate for Payer: Cofinity Commercial |
$374.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.85
|
| Rate for Payer: Healthscope Commercial |
$391.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.09
|
| Rate for Payer: Nomi Health Commercial |
$357.03
|
| Rate for Payer: PACE Senior Care Partners |
$103.41
|
| Rate for Payer: PACE SWMI |
$108.85
|
| Rate for Payer: PHP Commercial |
$370.09
|
| Rate for Payer: PHP Medicare Advantage |
$108.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.01
|
| Rate for Payer: Priority Health HMO/PPO |
$378.80
|
| Rate for Payer: Priority Health Medicare |
$109.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.72
|
| Rate for Payer: Railroad Medicare Medicare |
$108.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.15
|
| Rate for Payer: UHC Core |
$363.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.85
|
| Rate for Payer: UHC Exchange |
$108.85
|
| Rate for Payer: UHC Medicare Advantage |
$108.85
|
| Rate for Payer: VA VA |
$108.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.55
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$435.40
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$283.01 |
| Max. Negotiated Rate |
$391.86 |
| Rate for Payer: Aetna Commercial |
$370.09
|
| Rate for Payer: BCBS Trust/PPO |
$355.42
|
| Rate for Payer: BCN Commercial |
$336.48
|
| Rate for Payer: Cash Price |
$348.32
|
| Rate for Payer: Cofinity Commercial |
$374.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.32
|
| Rate for Payer: Healthscope Commercial |
$391.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.09
|
| Rate for Payer: Nomi Health Commercial |
$357.03
|
| Rate for Payer: PHP Commercial |
$370.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.01
|
| Rate for Payer: Priority Health HMO/PPO |
$378.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$383.15
|
| Rate for Payer: UHC Core |
$363.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.55
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: BCBS Trust/PPO |
$41.61
|
| Rate for Payer: BCN Commercial |
$39.40
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.93
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$12.74
|
| Rate for Payer: BCBS Trust/PPO |
$41.91
|
| Rate for Payer: BCN Commercial |
$39.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.74
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.38
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.74
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: Railroad Medicare Medicare |
$12.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.74
|
| Rate for Payer: UHC Exchange |
$12.74
|
| Rate for Payer: UHC Medicare Advantage |
$12.74
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$12.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$138.37
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.86 |
| Max. Negotiated Rate |
$124.53 |
| Rate for Payer: Aetna Commercial |
$117.61
|
| Rate for Payer: Aetna Medicare |
$35.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.24
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$34.59
|
| Rate for Payer: BCBS Trust/PPO |
$113.75
|
| Rate for Payer: BCN Commercial |
$107.58
|
| Rate for Payer: BCN Medicare Advantage |
$34.59
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$119.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.59
|
| Rate for Payer: Healthscope Commercial |
$124.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.78
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.32
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.61
|
| Rate for Payer: Nomi Health Commercial |
$113.46
|
| Rate for Payer: PACE Senior Care Partners |
$32.86
|
| Rate for Payer: PACE SWMI |
$34.59
|
| Rate for Payer: PHP Commercial |
$117.61
|
| Rate for Payer: PHP Medicare Advantage |
$34.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.94
|
| Rate for Payer: Priority Health HMO/PPO |
$120.38
|
| Rate for Payer: Priority Health Medicare |
$34.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.71
|
| Rate for Payer: Railroad Medicare Medicare |
$34.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.77
|
| Rate for Payer: UHC Core |
$115.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.59
|
| Rate for Payer: UHC Exchange |
$34.59
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$34.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.78
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$138.37
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.94 |
| Max. Negotiated Rate |
$124.53 |
| Rate for Payer: Aetna Commercial |
$117.61
|
| Rate for Payer: BCBS Trust/PPO |
$112.95
|
| Rate for Payer: BCN Commercial |
$106.93
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$119.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.70
|
| Rate for Payer: Healthscope Commercial |
$124.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.61
|
| Rate for Payer: Nomi Health Commercial |
$113.46
|
| Rate for Payer: PHP Commercial |
$117.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.94
|
| Rate for Payer: Priority Health HMO/PPO |
$120.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.77
|
| Rate for Payer: UHC Core |
$115.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.78
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,360.73
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,534.47 |
| Max. Negotiated Rate |
$2,124.66 |
| Rate for Payer: Aetna Commercial |
$2,006.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.06
|
| Rate for Payer: BCN Commercial |
$1,824.37
|
| Rate for Payer: Cash Price |
$1,888.58
|
| Rate for Payer: Cofinity Commercial |
$2,030.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.58
|
| Rate for Payer: Healthscope Commercial |
$2,124.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,770.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.62
|
| Rate for Payer: Nomi Health Commercial |
$1,935.80
|
| Rate for Payer: PHP Commercial |
$2,006.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,053.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,581.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,077.44
|
| Rate for Payer: UHC Core |
$1,971.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,770.55
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,360.73
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.67 |
| Max. Negotiated Rate |
$2,124.66 |
| Rate for Payer: Aetna Commercial |
$2,006.62
|
| Rate for Payer: Aetna Medicare |
$613.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$737.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$737.73
|
| Rate for Payer: BCBS Complete |
$944.29
|
| Rate for Payer: BCBS MAPPO |
$590.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.76
|
| Rate for Payer: BCN Commercial |
$1,835.47
|
| Rate for Payer: BCN Medicare Advantage |
$590.18
|
| Rate for Payer: Cash Price |
$1,888.58
|
| Rate for Payer: Cofinity Commercial |
$2,030.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,888.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$590.18
|
| Rate for Payer: Healthscope Commercial |
$2,124.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,770.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$619.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$678.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,006.62
|
| Rate for Payer: Nomi Health Commercial |
$1,935.80
|
| Rate for Payer: PACE Senior Care Partners |
$560.67
|
| Rate for Payer: PACE SWMI |
$590.18
|
| Rate for Payer: PHP Commercial |
$2,006.62
|
| Rate for Payer: PHP Medicare Advantage |
$590.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,053.84
|
| Rate for Payer: Priority Health Medicare |
$596.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,581.69
|
| Rate for Payer: Railroad Medicare Medicare |
$590.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,077.44
|
| Rate for Payer: UHC Core |
$1,971.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$590.18
|
| Rate for Payer: UHC Exchange |
$590.18
|
| Rate for Payer: UHC Medicare Advantage |
$590.18
|
| Rate for Payer: VA VA |
$590.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,770.55
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$502.41
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$119.32 |
| Max. Negotiated Rate |
$452.17 |
| Rate for Payer: Aetna Commercial |
$427.05
|
| Rate for Payer: Aetna Medicare |
$130.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.00
|
| Rate for Payer: BCBS Complete |
$200.96
|
| Rate for Payer: BCBS MAPPO |
$125.60
|
| Rate for Payer: BCBS Trust/PPO |
$413.03
|
| Rate for Payer: BCN Commercial |
$390.62
|
| Rate for Payer: BCN Medicare Advantage |
$125.60
|
| Rate for Payer: Cash Price |
$401.93
|
| Rate for Payer: Cofinity Commercial |
$432.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.60
|
| Rate for Payer: Healthscope Commercial |
$452.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.05
|
| Rate for Payer: Nomi Health Commercial |
$411.98
|
| Rate for Payer: PACE Senior Care Partners |
$119.32
|
| Rate for Payer: PACE SWMI |
$125.60
|
| Rate for Payer: PHP Commercial |
$427.05
|
| Rate for Payer: PHP Medicare Advantage |
$125.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.57
|
| Rate for Payer: Priority Health HMO/PPO |
$437.10
|
| Rate for Payer: Priority Health Medicare |
$126.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.61
|
| Rate for Payer: Railroad Medicare Medicare |
$125.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.12
|
| Rate for Payer: UHC Core |
$419.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.60
|
| Rate for Payer: UHC Exchange |
$125.60
|
| Rate for Payer: UHC Medicare Advantage |
$125.60
|
| Rate for Payer: VA VA |
$125.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.81
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$502.41
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.57 |
| Max. Negotiated Rate |
$452.17 |
| Rate for Payer: Aetna Commercial |
$427.05
|
| Rate for Payer: BCBS Trust/PPO |
$410.12
|
| Rate for Payer: BCN Commercial |
$388.26
|
| Rate for Payer: Cash Price |
$401.93
|
| Rate for Payer: Cofinity Commercial |
$432.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.93
|
| Rate for Payer: Healthscope Commercial |
$452.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.05
|
| Rate for Payer: Nomi Health Commercial |
$411.98
|
| Rate for Payer: PHP Commercial |
$427.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.57
|
| Rate for Payer: Priority Health HMO/PPO |
$437.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.12
|
| Rate for Payer: UHC Core |
$419.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.81
|
|
|
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 EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$552.65
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$131.25 |
| Max. Negotiated Rate |
$497.38 |
| Rate for Payer: Aetna Commercial |
$469.75
|
| Rate for Payer: Aetna Medicare |
$143.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.70
|
| Rate for Payer: BCBS Complete |
$221.06
|
| Rate for Payer: BCBS MAPPO |
$138.16
|
| Rate for Payer: BCBS Trust/PPO |
$454.33
|
| Rate for Payer: BCN Commercial |
$429.69
|
| Rate for Payer: BCN Medicare Advantage |
$138.16
|
| 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: Health Alliance Plan Medicare Advantage |
$138.16
|
| Rate for Payer: Healthscope Commercial |
$497.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.75
|
| Rate for Payer: Nomi Health Commercial |
$453.17
|
| Rate for Payer: PACE Senior Care Partners |
$131.25
|
| Rate for Payer: PACE SWMI |
$138.16
|
| Rate for Payer: PHP Commercial |
$469.75
|
| Rate for Payer: PHP Medicare Advantage |
$138.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.22
|
| Rate for Payer: Priority Health HMO/PPO |
$480.81
|
| Rate for Payer: Priority Health Medicare |
$139.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.28
|
| Rate for Payer: Railroad Medicare Medicare |
$138.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.33
|
| Rate for Payer: UHC Core |
$461.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.16
|
| Rate for Payer: UHC Exchange |
$138.16
|
| Rate for Payer: UHC Medicare Advantage |
$138.16
|
| Rate for Payer: VA VA |
$138.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.49
|
|
|
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 |
$4,328.59
|
| 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 |
$4,882.01
|
| Rate for Payer: Mclaren Medicaid |
$4,122.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.70
|
| Rate for Payer: Meridian Medicaid |
$4,328.59
|
| 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 |
$4,122.20
|
| 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 |
$4,122.20
|
| Rate for Payer: VA VA |
$1,627.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.01
|
|
|
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 |
$4,882.01
|
| 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 |
$4,882.01
|
|
|
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 |
$4,882.01
|
| 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 |
$4,882.01
|
|
|
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 |
$4,328.59
|
| 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 |
$4,882.01
|
| Rate for Payer: Mclaren Medicaid |
$4,122.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.70
|
| Rate for Payer: Meridian Medicaid |
$4,328.59
|
| 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 |
$4,122.20
|
| 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 |
$4,122.20
|
| Rate for Payer: VA VA |
$1,627.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.01
|
|
|
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 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 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
|
|
