|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
IP
|
$1,837.50
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,120.69 |
| Max. Negotiated Rate |
$1,653.75 |
| Rate for Payer: Aetna Commercial |
$1,561.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,420.02
|
| Rate for Payer: BCN Commercial |
$1,420.02
|
| Rate for Payer: Cash Price |
$1,470.00
|
| Rate for Payer: Cofinity Commercial |
$1,580.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,470.00
|
| Rate for Payer: Healthscope Commercial |
$1,653.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,378.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,561.88
|
| Rate for Payer: PHP Commercial |
$1,561.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,286.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,598.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,120.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,617.00
|
| Rate for Payer: UHC Core |
$1,534.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,378.12
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$157.50
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.41 |
| Max. Negotiated Rate |
$141.75 |
| Rate for Payer: Aetna Commercial |
$133.88
|
| Rate for Payer: Aetna Medicare |
$40.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.22
|
| Rate for Payer: BCBS Complete |
$63.00
|
| Rate for Payer: BCBS MAPPO |
$39.38
|
| Rate for Payer: BCBS Trust/PPO |
$122.46
|
| Rate for Payer: BCN Commercial |
$122.46
|
| Rate for Payer: BCN Medicare Advantage |
$39.38
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cofinity Commercial |
$135.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.38
|
| Rate for Payer: Healthscope Commercial |
$141.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.88
|
| Rate for Payer: PACE Senior Care Partners |
$37.41
|
| Rate for Payer: PACE SWMI |
$39.38
|
| Rate for Payer: PHP Commercial |
$133.88
|
| Rate for Payer: PHP Medicare Advantage |
$39.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.02
|
| Rate for Payer: Priority Health Medicare |
$39.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.06
|
| Rate for Payer: Railroad Medicare Medicare |
$39.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.60
|
| Rate for Payer: UHC Core |
$131.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.38
|
| Rate for Payer: UHC Medicare Advantage |
$40.56
|
| Rate for Payer: VA VA |
$39.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.12
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
IP
|
$157.50
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$96.06 |
| Max. Negotiated Rate |
$141.75 |
| Rate for Payer: Aetna Commercial |
$133.88
|
| Rate for Payer: BCBS Trust/PPO |
$121.72
|
| Rate for Payer: BCN Commercial |
$121.72
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cofinity Commercial |
$135.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.00
|
| Rate for Payer: Healthscope Commercial |
$141.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.88
|
| Rate for Payer: PHP Commercial |
$133.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.60
|
| Rate for Payer: UHC Core |
$131.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.12
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$472.50
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.18 |
| Max. Negotiated Rate |
$425.25 |
| Rate for Payer: Aetna Commercial |
$401.62
|
| Rate for Payer: BCBS Trust/PPO |
$365.15
|
| Rate for Payer: BCN Commercial |
$365.15
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.00
|
| Rate for Payer: Healthscope Commercial |
$425.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.62
|
| Rate for Payer: PHP Commercial |
$401.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.80
|
| Rate for Payer: UHC Core |
$394.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.38
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$472.50
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.22 |
| Max. Negotiated Rate |
$425.25 |
| Rate for Payer: Aetna Commercial |
$401.62
|
| Rate for Payer: Aetna Medicare |
$122.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.66
|
| Rate for Payer: BCBS Complete |
$189.00
|
| Rate for Payer: BCBS MAPPO |
$118.12
|
| Rate for Payer: BCBS Trust/PPO |
$367.37
|
| Rate for Payer: BCN Commercial |
$367.37
|
| Rate for Payer: BCN Medicare Advantage |
$118.12
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cofinity Commercial |
$406.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.12
|
| Rate for Payer: Healthscope Commercial |
$425.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.62
|
| Rate for Payer: PACE Senior Care Partners |
$112.22
|
| Rate for Payer: PACE SWMI |
$118.12
|
| Rate for Payer: PHP Commercial |
$401.62
|
| Rate for Payer: PHP Medicare Advantage |
$118.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$411.08
|
| Rate for Payer: Priority Health Medicare |
$118.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.18
|
| Rate for Payer: Railroad Medicare Medicare |
$118.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.80
|
| Rate for Payer: UHC Core |
$394.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.12
|
| Rate for Payer: UHC Medicare Advantage |
$121.67
|
| Rate for Payer: VA VA |
$118.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.38
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,320.50
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,415.27 |
| Max. Negotiated Rate |
$2,088.45 |
| Rate for Payer: Aetna Commercial |
$1,972.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.28
|
| Rate for Payer: BCN Commercial |
$1,793.28
|
| Rate for Payer: Cash Price |
$1,856.40
|
| Rate for Payer: Cofinity Commercial |
$1,995.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,856.40
|
| Rate for Payer: Healthscope Commercial |
$2,088.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,740.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,972.42
|
| Rate for Payer: PHP Commercial |
$1,972.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,624.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,018.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,415.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,042.04
|
| Rate for Payer: UHC Core |
$1,937.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,740.38
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,320.50
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$551.12 |
| Max. Negotiated Rate |
$2,088.45 |
| Rate for Payer: Aetna Commercial |
$1,972.42
|
| Rate for Payer: Aetna Medicare |
$603.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$725.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$725.16
|
| Rate for Payer: BCBS Complete |
$928.20
|
| Rate for Payer: BCBS MAPPO |
$580.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.19
|
| Rate for Payer: BCN Commercial |
$1,804.19
|
| Rate for Payer: BCN Medicare Advantage |
$580.12
|
| Rate for Payer: Cash Price |
$1,856.40
|
| Rate for Payer: Cofinity Commercial |
$1,995.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,856.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.12
|
| Rate for Payer: Healthscope Commercial |
$2,088.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,740.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$609.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$667.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,972.42
|
| Rate for Payer: PACE Senior Care Partners |
$551.12
|
| Rate for Payer: PACE SWMI |
$580.12
|
| Rate for Payer: PHP Commercial |
$1,972.42
|
| Rate for Payer: PHP Medicare Advantage |
$580.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,624.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,018.84
|
| Rate for Payer: Priority Health Medicare |
$580.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,415.27
|
| Rate for Payer: Railroad Medicare Medicare |
$580.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,042.04
|
| Rate for Payer: UHC Core |
$1,937.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$580.12
|
| Rate for Payer: UHC Medicare Advantage |
$597.53
|
| Rate for Payer: VA VA |
$580.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,740.38
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$16,922.27
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,019.04 |
| Max. Negotiated Rate |
$15,230.04 |
| Rate for Payer: Aetna Commercial |
$14,383.93
|
| Rate for Payer: Aetna Medicare |
$4,399.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,288.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,288.21
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$4,230.57
|
| Rate for Payer: BCBS Trust/PPO |
$13,157.06
|
| Rate for Payer: BCN Commercial |
$13,157.06
|
| Rate for Payer: BCN Medicare Advantage |
$4,230.57
|
| Rate for Payer: Cash Price |
$13,537.82
|
| Rate for Payer: Cash Price |
$13,537.82
|
| Rate for Payer: Cofinity Commercial |
$14,553.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,537.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,230.57
|
| Rate for Payer: Healthscope Commercial |
$15,230.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,691.70
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,442.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,865.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,383.93
|
| Rate for Payer: PACE Senior Care Partners |
$4,019.04
|
| Rate for Payer: PACE SWMI |
$4,230.57
|
| Rate for Payer: PHP Commercial |
$14,383.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,230.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,845.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,722.37
|
| Rate for Payer: Priority Health Medicare |
$4,230.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,320.89
|
| Rate for Payer: Railroad Medicare Medicare |
$4,230.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,891.60
|
| Rate for Payer: UHC Core |
$14,130.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,230.57
|
| Rate for Payer: UHC Medicare Advantage |
$4,357.48
|
| Rate for Payer: VA VA |
$4,230.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,691.70
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$16,922.27
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,320.89 |
| Max. Negotiated Rate |
$15,230.04 |
| Rate for Payer: Aetna Commercial |
$14,383.93
|
| Rate for Payer: BCBS Trust/PPO |
$13,077.53
|
| Rate for Payer: BCN Commercial |
$13,077.53
|
| Rate for Payer: Cash Price |
$13,537.82
|
| Rate for Payer: Cofinity Commercial |
$14,553.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,537.82
|
| Rate for Payer: Healthscope Commercial |
$15,230.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,691.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,383.93
|
| Rate for Payer: PHP Commercial |
$14,383.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,845.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,722.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,320.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,891.60
|
| Rate for Payer: UHC Core |
$14,130.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,691.70
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,151.29
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,141.77 |
| Max. Negotiated Rate |
$4,636.16 |
| Rate for Payer: Aetna Commercial |
$4,378.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.92
|
| Rate for Payer: BCN Commercial |
$3,980.92
|
| Rate for Payer: Cash Price |
$4,121.03
|
| Rate for Payer: Cofinity Commercial |
$4,430.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,121.03
|
| Rate for Payer: Healthscope Commercial |
$4,636.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,863.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,378.60
|
| Rate for Payer: PHP Commercial |
$4,378.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,605.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,141.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,533.14
|
| Rate for Payer: UHC Core |
$4,301.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,863.47
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,151.29
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,223.43 |
| Max. Negotiated Rate |
$7,577.51 |
| Rate for Payer: Aetna Commercial |
$4,378.60
|
| Rate for Payer: Aetna Medicare |
$1,339.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,609.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,609.78
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$1,287.82
|
| Rate for Payer: BCBS Trust/PPO |
$4,005.13
|
| Rate for Payer: BCN Commercial |
$4,005.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,287.82
|
| Rate for Payer: Cash Price |
$4,121.03
|
| Rate for Payer: Cash Price |
$4,121.03
|
| Rate for Payer: Cofinity Commercial |
$4,430.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,121.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,287.82
|
| Rate for Payer: Healthscope Commercial |
$4,636.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,863.47
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,352.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,481.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,378.60
|
| Rate for Payer: PACE Senior Care Partners |
$1,223.43
|
| Rate for Payer: PACE SWMI |
$1,287.82
|
| Rate for Payer: PHP Commercial |
$4,378.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,287.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,605.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.62
|
| Rate for Payer: Priority Health Medicare |
$1,287.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,141.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,287.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,533.14
|
| Rate for Payer: UHC Core |
$4,301.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,287.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,326.46
|
| Rate for Payer: VA VA |
$1,287.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,863.47
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$420.35
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.83 |
| Max. Negotiated Rate |
$378.32 |
| Rate for Payer: Aetna Commercial |
$357.30
|
| Rate for Payer: Aetna Medicare |
$109.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.36
|
| Rate for Payer: BCBS Complete |
$168.14
|
| Rate for Payer: BCBS MAPPO |
$105.09
|
| Rate for Payer: BCBS Trust/PPO |
$326.82
|
| Rate for Payer: BCN Commercial |
$326.82
|
| Rate for Payer: BCN Medicare Advantage |
$105.09
|
| Rate for Payer: Cash Price |
$336.28
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.09
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.30
|
| Rate for Payer: PACE Senior Care Partners |
$99.83
|
| Rate for Payer: PACE SWMI |
$105.09
|
| Rate for Payer: PHP Commercial |
$357.30
|
| Rate for Payer: PHP Medicare Advantage |
$105.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.70
|
| Rate for Payer: Priority Health Medicare |
$105.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.37
|
| Rate for Payer: Railroad Medicare Medicare |
$105.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.91
|
| Rate for Payer: UHC Core |
$350.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.09
|
| Rate for Payer: UHC Medicare Advantage |
$108.24
|
| Rate for Payer: VA VA |
$105.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.26
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$420.35
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.37 |
| Max. Negotiated Rate |
$378.32 |
| Rate for Payer: Aetna Commercial |
$357.30
|
| Rate for Payer: BCBS Trust/PPO |
$324.85
|
| Rate for Payer: BCN Commercial |
$324.85
|
| Rate for Payer: Cash Price |
$336.28
|
| Rate for Payer: Cofinity Commercial |
$361.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.28
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$357.30
|
| Rate for Payer: PHP Commercial |
$357.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$365.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.91
|
| Rate for Payer: UHC Core |
$350.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.26
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,025.83
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,993.95 |
| Max. Negotiated Rate |
$16,223.25 |
| Rate for Payer: Aetna Commercial |
$15,321.96
|
| Rate for Payer: BCBS Trust/PPO |
$13,930.36
|
| Rate for Payer: BCN Commercial |
$13,930.36
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cofinity Commercial |
$15,502.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,420.66
|
| Rate for Payer: Healthscope Commercial |
$16,223.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,519.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,321.96
|
| Rate for Payer: PHP Commercial |
$15,321.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,618.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,682.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,993.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,862.73
|
| Rate for Payer: UHC Core |
$15,051.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,519.37
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,025.83
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,281.13 |
| Max. Negotiated Rate |
$16,223.25 |
| Rate for Payer: Aetna Commercial |
$15,321.96
|
| Rate for Payer: Aetna Medicare |
$4,686.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,633.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,633.07
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$4,506.46
|
| Rate for Payer: BCBS Trust/PPO |
$14,015.08
|
| Rate for Payer: BCN Commercial |
$14,015.08
|
| Rate for Payer: BCN Medicare Advantage |
$4,506.46
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cash Price |
$14,420.66
|
| Rate for Payer: Cofinity Commercial |
$15,502.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,420.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,506.46
|
| Rate for Payer: Healthscope Commercial |
$16,223.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,519.37
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,731.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,182.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,321.96
|
| Rate for Payer: PACE Senior Care Partners |
$4,281.13
|
| Rate for Payer: PACE SWMI |
$4,506.46
|
| Rate for Payer: PHP Commercial |
$15,321.96
|
| Rate for Payer: PHP Medicare Advantage |
$4,506.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,618.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,682.47
|
| Rate for Payer: Priority Health Medicare |
$4,506.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,993.95
|
| Rate for Payer: Railroad Medicare Medicare |
$4,506.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,862.73
|
| Rate for Payer: UHC Core |
$15,051.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,506.46
|
| Rate for Payer: UHC Medicare Advantage |
$4,641.65
|
| Rate for Payer: VA VA |
$4,506.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,519.37
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,786.68
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,374.34 |
| Max. Negotiated Rate |
$5,208.01 |
| Rate for Payer: Aetna Commercial |
$4,918.68
|
| Rate for Payer: Aetna Medicare |
$1,504.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,808.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,808.34
|
| Rate for Payer: BCBS Complete |
$2,314.67
|
| Rate for Payer: BCBS MAPPO |
$1,446.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,499.14
|
| Rate for Payer: BCN Commercial |
$4,499.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,446.67
|
| Rate for Payer: Cash Price |
$4,629.34
|
| Rate for Payer: Cofinity Commercial |
$4,976.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,629.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,446.67
|
| Rate for Payer: Healthscope Commercial |
$5,208.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,340.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,519.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,663.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,918.68
|
| Rate for Payer: PACE Senior Care Partners |
$1,374.34
|
| Rate for Payer: PACE SWMI |
$1,446.67
|
| Rate for Payer: PHP Commercial |
$4,918.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,446.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,050.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,034.41
|
| Rate for Payer: Priority Health Medicare |
$1,446.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,529.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,446.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,092.28
|
| Rate for Payer: UHC Core |
$4,831.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,446.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,490.07
|
| Rate for Payer: VA VA |
$1,446.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,340.01
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,786.68
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,529.30 |
| Max. Negotiated Rate |
$5,208.01 |
| Rate for Payer: Aetna Commercial |
$4,918.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,471.95
|
| Rate for Payer: BCN Commercial |
$4,471.95
|
| Rate for Payer: Cash Price |
$4,629.34
|
| Rate for Payer: Cofinity Commercial |
$4,976.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,629.34
|
| Rate for Payer: Healthscope Commercial |
$5,208.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,340.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,918.68
|
| Rate for Payer: PHP Commercial |
$4,918.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,050.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,034.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,529.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,092.28
|
| Rate for Payer: UHC Core |
$4,831.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,340.01
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$130.53
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$117.48 |
| Rate for Payer: Aetna Commercial |
$110.95
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.79
|
| Rate for Payer: BCBS Complete |
$52.21
|
| Rate for Payer: BCBS MAPPO |
$32.63
|
| Rate for Payer: BCBS Trust/PPO |
$101.49
|
| Rate for Payer: BCN Commercial |
$101.49
|
| Rate for Payer: BCN Medicare Advantage |
$32.63
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cofinity Commercial |
$112.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$117.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.95
|
| Rate for Payer: PACE Senior Care Partners |
$31.00
|
| Rate for Payer: PACE SWMI |
$32.63
|
| Rate for Payer: PHP Commercial |
$110.95
|
| Rate for Payer: PHP Medicare Advantage |
$32.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.56
|
| Rate for Payer: Priority Health Medicare |
$32.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.61
|
| Rate for Payer: Railroad Medicare Medicare |
$32.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.87
|
| Rate for Payer: UHC Core |
$108.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.63
|
| Rate for Payer: UHC Medicare Advantage |
$33.61
|
| Rate for Payer: VA VA |
$32.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.90
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$130.53
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$79.61 |
| Max. Negotiated Rate |
$117.48 |
| Rate for Payer: Aetna Commercial |
$110.95
|
| Rate for Payer: BCBS Trust/PPO |
$100.87
|
| Rate for Payer: BCN Commercial |
$100.87
|
| Rate for Payer: Cash Price |
$104.42
|
| Rate for Payer: Cofinity Commercial |
$112.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.42
|
| Rate for Payer: Healthscope Commercial |
$117.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.95
|
| Rate for Payer: PHP Commercial |
$110.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.87
|
| Rate for Payer: UHC Core |
$108.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.90
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$344.16
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$209.90 |
| Max. Negotiated Rate |
$309.74 |
| Rate for Payer: Aetna Commercial |
$292.54
|
| Rate for Payer: BCBS Trust/PPO |
$265.97
|
| Rate for Payer: BCN Commercial |
$265.97
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.33
|
| Rate for Payer: Healthscope Commercial |
$309.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.54
|
| Rate for Payer: PHP Commercial |
$292.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.86
|
| Rate for Payer: UHC Core |
$287.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.12
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$344.16
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.74 |
| Max. Negotiated Rate |
$309.74 |
| Rate for Payer: Aetna Commercial |
$292.54
|
| Rate for Payer: Aetna Medicare |
$89.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.55
|
| Rate for Payer: BCBS Complete |
$170.23
|
| Rate for Payer: BCBS MAPPO |
$86.04
|
| Rate for Payer: BCBS Trust/PPO |
$267.58
|
| Rate for Payer: BCN Commercial |
$267.58
|
| Rate for Payer: BCN Medicare Advantage |
$86.04
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cash Price |
$275.33
|
| Rate for Payer: Cofinity Commercial |
$295.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.04
|
| Rate for Payer: Healthscope Commercial |
$309.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.12
|
| Rate for Payer: Mclaren Medicaid |
$162.12
|
| Rate for Payer: Meridian Medicaid |
$170.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.54
|
| Rate for Payer: PACE Senior Care Partners |
$81.74
|
| Rate for Payer: PACE SWMI |
$86.04
|
| Rate for Payer: PHP Commercial |
$292.54
|
| Rate for Payer: PHP Medicare Advantage |
$86.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.42
|
| Rate for Payer: Priority Health Medicare |
$86.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.90
|
| Rate for Payer: Railroad Medicare Medicare |
$86.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.86
|
| Rate for Payer: UHC Core |
$287.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.04
|
| Rate for Payer: UHC Medicare Advantage |
$88.62
|
| Rate for Payer: VA VA |
$86.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.12
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$357.96
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$218.32 |
| Max. Negotiated Rate |
$322.16 |
| Rate for Payer: Aetna Commercial |
$304.27
|
| Rate for Payer: BCBS Trust/PPO |
$276.63
|
| Rate for Payer: BCN Commercial |
$276.63
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cofinity Commercial |
$307.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.37
|
| Rate for Payer: Healthscope Commercial |
$322.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.27
|
| Rate for Payer: PHP Commercial |
$304.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.00
|
| Rate for Payer: UHC Core |
$298.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.47
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$357.96
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$85.02 |
| Max. Negotiated Rate |
$322.16 |
| Rate for Payer: Aetna Commercial |
$304.27
|
| Rate for Payer: Aetna Medicare |
$93.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.86
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$89.49
|
| Rate for Payer: BCBS Trust/PPO |
$278.31
|
| Rate for Payer: BCN Commercial |
$278.31
|
| Rate for Payer: BCN Medicare Advantage |
$89.49
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cash Price |
$286.37
|
| Rate for Payer: Cofinity Commercial |
$307.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.49
|
| Rate for Payer: Healthscope Commercial |
$322.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.47
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.27
|
| Rate for Payer: PACE Senior Care Partners |
$85.02
|
| Rate for Payer: PACE SWMI |
$89.49
|
| Rate for Payer: PHP Commercial |
$304.27
|
| Rate for Payer: PHP Medicare Advantage |
$89.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.43
|
| Rate for Payer: Priority Health Medicare |
$89.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$218.32
|
| Rate for Payer: Railroad Medicare Medicare |
$89.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.00
|
| Rate for Payer: UHC Core |
$298.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.49
|
| Rate for Payer: UHC Medicare Advantage |
$92.17
|
| Rate for Payer: VA VA |
$89.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.47
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$241.54
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$217.39 |
| Rate for Payer: Aetna Commercial |
$205.31
|
| Rate for Payer: Aetna Medicare |
$62.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.48
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$60.38
|
| Rate for Payer: BCBS Trust/PPO |
$187.80
|
| Rate for Payer: BCN Commercial |
$187.80
|
| Rate for Payer: BCN Medicare Advantage |
$60.38
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.16
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.31
|
| Rate for Payer: PACE Senior Care Partners |
$57.37
|
| Rate for Payer: PACE SWMI |
$60.38
|
| Rate for Payer: PHP Commercial |
$205.31
|
| Rate for Payer: PHP Medicare Advantage |
$60.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.14
|
| Rate for Payer: Priority Health Medicare |
$60.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.32
|
| Rate for Payer: Railroad Medicare Medicare |
$60.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.56
|
| Rate for Payer: UHC Core |
$201.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.38
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: VA VA |
$60.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.16
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$241.54
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$147.32 |
| Max. Negotiated Rate |
$217.39 |
| Rate for Payer: Aetna Commercial |
$205.31
|
| Rate for Payer: BCBS Trust/PPO |
$186.66
|
| Rate for Payer: BCN Commercial |
$186.66
|
| Rate for Payer: Cash Price |
$193.23
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.23
|
| Rate for Payer: Healthscope Commercial |
$217.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.31
|
| Rate for Payer: PHP Commercial |
$205.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.56
|
| Rate for Payer: UHC Core |
$201.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.16
|
|
