|
HC CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$31.83
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
IP
|
$26.53
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
OP
|
$26.53
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
IP
|
$507.83
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$353.45 |
| Max. Negotiated Rate |
$457.05 |
| Rate for Payer: Aetna Commercial |
$431.66
|
| Rate for Payer: BCBS Trust/PPO |
$419.42
|
| Rate for Payer: BCN Commercial |
$419.42
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cofinity Commercial |
$436.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.26
|
| Rate for Payer: Healthscope Commercial |
$457.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Nomi Health Commercial |
$416.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$380.87
|
| Rate for Payer: PHP Commercial |
$431.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$441.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.89
|
| Rate for Payer: UHC Core |
$424.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.87
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
OP
|
$507.83
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$89.53 |
| Max. Negotiated Rate |
$457.05 |
| Rate for Payer: Aetna Commercial |
$431.66
|
| Rate for Payer: Aetna Medicare |
$132.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.70
|
| Rate for Payer: BCBS Complete |
$94.00
|
| Rate for Payer: BCBS MAPPO |
$126.96
|
| Rate for Payer: BCBS Trust/PPO |
$417.49
|
| Rate for Payer: BCN Commercial |
$417.49
|
| Rate for Payer: BCN Medicare Advantage |
$126.96
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cofinity Commercial |
$436.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.96
|
| Rate for Payer: Healthscope Commercial |
$457.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.87
|
| Rate for Payer: Mclaren Medicaid |
$89.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.31
|
| Rate for Payer: Meridian Medicaid |
$94.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Nomi Health Commercial |
$416.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$380.87
|
| Rate for Payer: PACE Senior Care Partners |
$120.61
|
| Rate for Payer: PACE SWMI |
$126.96
|
| Rate for Payer: PHP Commercial |
$431.66
|
| Rate for Payer: PHP Medicare Advantage |
$126.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$441.81
|
| Rate for Payer: Priority Health Medicare |
$128.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.45
|
| Rate for Payer: Railroad Medicare Medicare |
$126.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.89
|
| Rate for Payer: UHC Core |
$424.04
|
| Rate for Payer: UHC Exchange |
$126.96
|
| Rate for Payer: UHC Medicaid |
$89.53
|
| Rate for Payer: UHC Medicare Advantage |
$126.96
|
| Rate for Payer: UHCCP Medicaid |
$89.53
|
| Rate for Payer: VA VA |
$126.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.87
|
|
|
HC CAST WEDGE
|
Facility
|
OP
|
$365.82
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$64.49 |
| Max. Negotiated Rate |
$329.24 |
| Rate for Payer: Aetna Commercial |
$310.95
|
| Rate for Payer: Aetna Medicare |
$95.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.32
|
| Rate for Payer: BCBS Complete |
$67.71
|
| Rate for Payer: BCBS MAPPO |
$91.45
|
| Rate for Payer: BCBS Trust/PPO |
$300.74
|
| Rate for Payer: BCN Commercial |
$300.74
|
| Rate for Payer: BCN Medicare Advantage |
$91.45
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cofinity Commercial |
$314.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.45
|
| Rate for Payer: Healthscope Commercial |
$329.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.37
|
| Rate for Payer: Mclaren Medicaid |
$64.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.03
|
| Rate for Payer: Meridian Medicaid |
$67.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.95
|
| Rate for Payer: Nomi Health Commercial |
$299.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.37
|
| Rate for Payer: PACE Senior Care Partners |
$86.88
|
| Rate for Payer: PACE SWMI |
$91.45
|
| Rate for Payer: PHP Commercial |
$310.95
|
| Rate for Payer: PHP Medicare Advantage |
$91.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.26
|
| Rate for Payer: Priority Health Medicare |
$92.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.61
|
| Rate for Payer: Railroad Medicare Medicare |
$91.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.92
|
| Rate for Payer: UHC Core |
$305.46
|
| Rate for Payer: UHC Exchange |
$91.45
|
| Rate for Payer: UHC Medicaid |
$64.49
|
| Rate for Payer: UHC Medicare Advantage |
$91.45
|
| Rate for Payer: UHCCP Medicaid |
$64.49
|
| Rate for Payer: VA VA |
$91.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.37
|
|
|
HC CAST WEDGE
|
Facility
|
IP
|
$365.82
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$254.61 |
| Max. Negotiated Rate |
$329.24 |
| Rate for Payer: Aetna Commercial |
$310.95
|
| Rate for Payer: BCBS Trust/PPO |
$302.13
|
| Rate for Payer: BCN Commercial |
$302.13
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cofinity Commercial |
$314.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.66
|
| Rate for Payer: Healthscope Commercial |
$329.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.95
|
| Rate for Payer: Nomi Health Commercial |
$299.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.37
|
| Rate for Payer: PHP Commercial |
$310.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.92
|
| Rate for Payer: UHC Core |
$305.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.37
|
|
|
HC CAST WINDOW
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$137.66 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: BCBS Trust/PPO |
$163.35
|
| Rate for Payer: BCN Commercial |
$163.35
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC CAST WINDOW
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna Medicare |
$51.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.81
|
| Rate for Payer: BCBS Complete |
$36.61
|
| Rate for Payer: BCBS MAPPO |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$162.60
|
| Rate for Payer: BCN Commercial |
$162.60
|
| Rate for Payer: BCN Medicare Advantage |
$49.45
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.45
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Mclaren Medicaid |
$34.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.92
|
| Rate for Payer: Meridian Medicaid |
$36.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Senior Care Partners |
$46.98
|
| Rate for Payer: PACE SWMI |
$49.45
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: PHP Medicare Advantage |
$49.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Medicare |
$49.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: Railroad Medicare Medicare |
$49.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHC Medicaid |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$49.45
|
| Rate for Payer: UHCCP Medicaid |
$34.87
|
| Rate for Payer: VA VA |
$49.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
IP
|
$61.55
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.83
|
| Rate for Payer: BCN Commercial |
$50.83
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
OP
|
$61.55
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.23
|
| Rate for Payer: BCBS Complete |
$11.39
|
| Rate for Payer: BCBS MAPPO |
$15.39
|
| Rate for Payer: BCBS Trust/PPO |
$50.60
|
| Rate for Payer: BCN Commercial |
$50.60
|
| Rate for Payer: BCN Medicare Advantage |
$15.39
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Mclaren Medicaid |
$10.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.16
|
| Rate for Payer: Meridian Medicaid |
$11.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$50.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PACE Senior Care Partners |
$14.62
|
| Rate for Payer: PACE SWMI |
$15.39
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: PHP Medicare Advantage |
$15.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.55
|
| Rate for Payer: Priority Health Medicare |
$15.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.84
|
| Rate for Payer: Railroad Medicare Medicare |
$15.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.16
|
| Rate for Payer: UHC Core |
$51.39
|
| Rate for Payer: UHC Exchange |
$15.39
|
| Rate for Payer: UHC Medicaid |
$10.85
|
| Rate for Payer: UHC Medicare Advantage |
$15.39
|
| Rate for Payer: UHCCP Medicaid |
$10.85
|
| Rate for Payer: VA VA |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna Medicare |
$15.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.44
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$14.75
|
| Rate for Payer: BCBS Trust/PPO |
$48.50
|
| Rate for Payer: BCN Commercial |
$48.50
|
| Rate for Payer: BCN Medicare Advantage |
$14.75
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.75
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.49
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.15
|
| Rate for Payer: Nomi Health Commercial |
$48.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE Senior Care Partners |
$14.01
|
| Rate for Payer: PACE SWMI |
$14.75
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: PHP Medicare Advantage |
$14.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.33
|
| Rate for Payer: Priority Health Medicare |
$14.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: Railroad Medicare Medicare |
$14.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.92
|
| Rate for Payer: UHC Core |
$49.27
|
| Rate for Payer: UHC Exchange |
$14.75
|
| Rate for Payer: UHC Medicaid |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$14.75
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$14.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.06 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: BCBS Trust/PPO |
$48.73
|
| Rate for Payer: BCN Commercial |
$48.73
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.15
|
| Rate for Payer: Nomi Health Commercial |
$48.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.92
|
| Rate for Payer: UHC Core |
$49.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC CATFISH IGE
|
Facility
|
IP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.36
|
| Rate for Payer: BCN Commercial |
$61.36
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC CATFISH IGE
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.22
|
| Rate for Payer: BCBS Complete |
$13.75
|
| Rate for Payer: BCBS MAPPO |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$61.07
|
| Rate for Payer: BCN Commercial |
$61.07
|
| Rate for Payer: BCN Medicare Advantage |
$18.57
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.57
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.50
|
| Rate for Payer: Meridian Medicaid |
$13.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Senior Care Partners |
$17.64
|
| Rate for Payer: PACE SWMI |
$18.57
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: PHP Medicare Advantage |
$18.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Medicare |
$18.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$18.57
|
| Rate for Payer: UHCCP Medicaid |
$13.10
|
| Rate for Payer: VA VA |
$18.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
IP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,971.06 |
| Max. Negotiated Rate |
$5,134.99 |
| Rate for Payer: Aetna Commercial |
$4,849.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,712.21
|
| Rate for Payer: BCN Commercial |
$4,712.21
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Commercial |
$4,906.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,134.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,279.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Nomi Health Commercial |
$4,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: PHP Commercial |
$4,849.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,963.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,971.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,020.88
|
| Rate for Payer: UHC Core |
$4,764.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,279.16
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
OP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,005.89 |
| Max. Negotiated Rate |
$5,134.99 |
| Rate for Payer: Aetna Commercial |
$4,849.72
|
| Rate for Payer: Aetna Medicare |
$1,483.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,782.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,782.98
|
| Rate for Payer: BCBS Complete |
$1,056.10
|
| Rate for Payer: BCBS MAPPO |
$1,426.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,690.53
|
| Rate for Payer: BCN Commercial |
$4,690.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,426.39
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Commercial |
$4,906.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,426.39
|
| Rate for Payer: Healthscope Commercial |
$5,134.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,279.16
|
| Rate for Payer: Mclaren Medicaid |
$1,005.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,497.71
|
| Rate for Payer: Meridian Medicaid |
$1,056.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,640.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,569.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Nomi Health Commercial |
$4,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,355.07
|
| Rate for Payer: PACE SWMI |
$1,426.39
|
| Rate for Payer: PHP Commercial |
$4,849.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,426.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,005.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,963.83
|
| Rate for Payer: Priority Health Medicare |
$1,440.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,971.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,426.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,020.88
|
| Rate for Payer: UHC Core |
$4,764.13
|
| Rate for Payer: UHC Exchange |
$1,426.39
|
| Rate for Payer: UHC Medicaid |
$1,005.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,426.39
|
| Rate for Payer: UHCCP Medicaid |
$1,005.89
|
| Rate for Payer: VA VA |
$1,426.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,279.16
|
|
|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
OP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,968.63 |
| Max. Negotiated Rate |
$10,049.73 |
| Rate for Payer: Aetna Commercial |
$9,491.41
|
| Rate for Payer: Aetna Medicare |
$2,903.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.49
|
| Rate for Payer: BCBS Complete |
$2,066.90
|
| Rate for Payer: BCBS MAPPO |
$2,791.59
|
| Rate for Payer: BCBS Trust/PPO |
$9,179.87
|
| Rate for Payer: BCN Commercial |
$9,179.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.59
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Commercial |
$9,603.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.59
|
| Rate for Payer: Healthscope Commercial |
$10,049.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,374.78
|
| Rate for Payer: Mclaren Medicaid |
$1,968.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,931.17
|
| Rate for Payer: Meridian Medicaid |
$2,066.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,210.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,070.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Nomi Health Commercial |
$9,156.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: PACE Senior Care Partners |
$2,652.01
|
| Rate for Payer: PACE SWMI |
$2,791.59
|
| Rate for Payer: PHP Commercial |
$9,491.41
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,968.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,714.74
|
| Rate for Payer: Priority Health Medicare |
$2,819.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,771.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,826.41
|
| Rate for Payer: UHC Core |
$9,323.92
|
| Rate for Payer: UHC Exchange |
$2,791.59
|
| Rate for Payer: UHC Medicaid |
$1,968.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.59
|
| Rate for Payer: UHCCP Medicaid |
$1,968.63
|
| Rate for Payer: VA VA |
$2,791.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,374.78
|
|
|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
IP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,771.79 |
| Max. Negotiated Rate |
$10,049.73 |
| Rate for Payer: Aetna Commercial |
$9,491.41
|
| Rate for Payer: BCBS Trust/PPO |
$9,222.30
|
| Rate for Payer: BCN Commercial |
$9,222.30
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Commercial |
$9,603.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Healthscope Commercial |
$10,049.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,374.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Nomi Health Commercial |
$9,156.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: PHP Commercial |
$9,491.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,714.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,771.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,826.41
|
| Rate for Payer: UHC Core |
$9,323.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,374.78
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
IP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,485.99 |
| Max. Negotiated Rate |
$3,214.64 |
| Rate for Payer: Aetna Commercial |
$3,036.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,949.97
|
| Rate for Payer: BCN Commercial |
$2,949.97
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Commercial |
$3,071.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Healthscope Commercial |
$3,214.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Nomi Health Commercial |
$2,928.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: PHP Commercial |
$3,036.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,107.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,485.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.20
|
| Rate for Payer: UHC Core |
$2,982.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.86
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
OP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$629.71 |
| Max. Negotiated Rate |
$3,214.64 |
| Rate for Payer: Aetna Commercial |
$3,036.05
|
| Rate for Payer: Aetna Medicare |
$928.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.19
|
| Rate for Payer: BCBS Complete |
$661.14
|
| Rate for Payer: BCBS MAPPO |
$892.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,936.39
|
| Rate for Payer: BCN Commercial |
$2,936.39
|
| Rate for Payer: BCN Medicare Advantage |
$892.96
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Commercial |
$3,071.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.96
|
| Rate for Payer: Healthscope Commercial |
$3,214.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.86
|
| Rate for Payer: Mclaren Medicaid |
$629.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.60
|
| Rate for Payer: Meridian Medicaid |
$661.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$982.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Nomi Health Commercial |
$2,928.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: PACE Senior Care Partners |
$848.31
|
| Rate for Payer: PACE SWMI |
$892.96
|
| Rate for Payer: PHP Commercial |
$3,036.05
|
| Rate for Payer: PHP Medicare Advantage |
$892.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,107.48
|
| Rate for Payer: Priority Health Medicare |
$901.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,485.99
|
| Rate for Payer: Railroad Medicare Medicare |
$892.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.20
|
| Rate for Payer: UHC Core |
$2,982.47
|
| Rate for Payer: UHC Exchange |
$892.96
|
| Rate for Payer: UHC Medicaid |
$629.71
|
| Rate for Payer: UHC Medicare Advantage |
$892.96
|
| Rate for Payer: UHCCP Medicaid |
$629.71
|
| Rate for Payer: VA VA |
$892.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.86
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
IP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.19 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: BCBS Trust/PPO |
$124.82
|
| Rate for Payer: BCN Commercial |
$124.82
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.99
|
| Rate for Payer: UHC Core |
$126.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
OP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.64 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna Medicare |
$39.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.23
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS MAPPO |
$37.78
|
| Rate for Payer: BCBS Trust/PPO |
$124.24
|
| Rate for Payer: BCN Commercial |
$124.24
|
| Rate for Payer: BCN Medicare Advantage |
$37.78
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.78
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Mclaren Medicaid |
$26.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.67
|
| Rate for Payer: Meridian Medicaid |
$27.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PACE Senior Care Partners |
$35.89
|
| Rate for Payer: PACE SWMI |
$37.78
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: PHP Medicare Advantage |
$37.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.48
|
| Rate for Payer: Priority Health Medicare |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.19
|
| Rate for Payer: Railroad Medicare Medicare |
$37.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.99
|
| Rate for Payer: UHC Core |
$126.19
|
| Rate for Payer: UHC Exchange |
$37.78
|
| Rate for Payer: UHC Medicaid |
$26.64
|
| Rate for Payer: UHC Medicare Advantage |
$37.78
|
| Rate for Payer: UHCCP Medicaid |
$26.64
|
| Rate for Payer: VA VA |
$37.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.77 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: Aetna Medicare |
$206.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.75
|
| Rate for Payer: BCBS Complete |
$146.75
|
| Rate for Payer: BCBS MAPPO |
$198.20
|
| Rate for Payer: BCBS Trust/PPO |
$651.77
|
| Rate for Payer: BCN Commercial |
$651.77
|
| Rate for Payer: BCN Medicare Advantage |
$198.20
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.20
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Mclaren Medicaid |
$139.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.11
|
| Rate for Payer: Meridian Medicaid |
$146.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: PACE Senior Care Partners |
$188.29
|
| Rate for Payer: PACE SWMI |
$198.20
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: PHP Medicare Advantage |
$198.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$689.74
|
| Rate for Payer: Priority Health Medicare |
$200.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.80
|
| Rate for Payer: Railroad Medicare Medicare |
$198.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.67
|
| Rate for Payer: UHC Core |
$662.00
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicaid |
$139.77
|
| Rate for Payer: UHC Medicare Advantage |
$198.20
|
| Rate for Payer: UHCCP Medicaid |
$139.77
|
| Rate for Payer: VA VA |
$198.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
IP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.80 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: BCBS Trust/PPO |
$654.78
|
| Rate for Payer: BCN Commercial |
$654.78
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$689.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.67
|
| Rate for Payer: UHC Core |
$662.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
