|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.72 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$100.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.69
|
| Rate for Payer: BCBS Complete |
$219.58
|
| Rate for Payer: BCBS MAPPO |
$96.55
|
| Rate for Payer: BCBS Trust/PPO |
$317.50
|
| Rate for Payer: BCN Commercial |
$300.28
|
| Rate for Payer: BCN Medicare Advantage |
$96.55
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Mclaren Medicaid |
$209.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.38
|
| Rate for Payer: Meridian Medicaid |
$219.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PACE Senior Care Partners |
$91.72
|
| Rate for Payer: PACE SWMI |
$96.55
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$96.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO |
$336.00
|
| Rate for Payer: Priority Health Medicare |
$97.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.76
|
| Rate for Payer: Railroad Medicare Medicare |
$96.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.86
|
| Rate for Payer: UHC Core |
$322.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.55
|
| Rate for Payer: UHC Exchange |
$96.55
|
| Rate for Payer: UHC Medicare Advantage |
$96.55
|
| Rate for Payer: UHCCP Medicaid |
$209.11
|
| Rate for Payer: VA VA |
$96.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: BCBS Trust/PPO |
$315.26
|
| Rate for Payer: BCN Commercial |
$298.46
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO |
$336.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.86
|
| Rate for Payer: UHC Core |
$322.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$742.95 |
| Max. Negotiated Rate |
$2,815.41 |
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: Aetna Medicare |
$813.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$977.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$977.57
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$782.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.72
|
| Rate for Payer: BCN Commercial |
$2,432.20
|
| Rate for Payer: BCN Medicare Advantage |
$782.06
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.06
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.17
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.16
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$899.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: PACE Senior Care Partners |
$742.95
|
| Rate for Payer: PACE SWMI |
$782.06
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: PHP Medicare Advantage |
$782.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,721.56
|
| Rate for Payer: Priority Health Medicare |
$789.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.91
|
| Rate for Payer: Railroad Medicare Medicare |
$782.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,752.84
|
| Rate for Payer: UHC Core |
$2,612.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.06
|
| Rate for Payer: UHC Exchange |
$782.06
|
| Rate for Payer: UHC Medicare Advantage |
$782.06
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$782.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.17
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.35 |
| Max. Negotiated Rate |
$2,815.41 |
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.57
|
| Rate for Payer: BCN Commercial |
$2,417.50
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$2,565.15
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,721.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,752.84
|
| Rate for Payer: UHC Core |
$2,612.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.17
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,029.42 |
| Max. Negotiated Rate |
$3,900.94 |
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: Aetna Medicare |
$1,126.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,354.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,354.49
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$1,083.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,563.29
|
| Rate for Payer: BCN Commercial |
$3,369.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.60
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.60
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.78
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.77
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,246.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: Nomi Health Commercial |
$3,554.19
|
| Rate for Payer: PACE Senior Care Partners |
$1,029.42
|
| Rate for Payer: PACE SWMI |
$1,083.60
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,770.91
|
| Rate for Payer: Priority Health Medicare |
$1,094.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,904.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,083.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,814.25
|
| Rate for Payer: UHC Core |
$3,619.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.60
|
| Rate for Payer: UHC Exchange |
$1,083.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.60
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$1,083.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.78
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,817.35 |
| Max. Negotiated Rate |
$3,900.94 |
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,538.15
|
| Rate for Payer: BCN Commercial |
$3,349.61
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: Nomi Health Commercial |
$3,554.19
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,770.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,904.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,814.25
|
| Rate for Payer: UHC Core |
$3,619.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.78
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,653.80 |
| Max. Negotiated Rate |
$2,289.87 |
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,076.91
|
| Rate for Payer: BCN Commercial |
$1,966.24
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: Nomi Health Commercial |
$2,086.33
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,213.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,704.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,238.98
|
| Rate for Payer: UHC Core |
$2,124.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.22
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.27 |
| Max. Negotiated Rate |
$2,365.09 |
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: Aetna Medicare |
$661.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$795.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$795.09
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$636.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,091.67
|
| Rate for Payer: BCN Commercial |
$1,978.19
|
| Rate for Payer: BCN Medicare Advantage |
$636.08
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.08
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.22
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$667.88
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$731.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: Nomi Health Commercial |
$2,086.33
|
| Rate for Payer: PACE Senior Care Partners |
$604.27
|
| Rate for Payer: PACE SWMI |
$636.08
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: PHP Medicare Advantage |
$636.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health HMO/PPO |
$2,213.54
|
| Rate for Payer: Priority Health Medicare |
$642.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,704.68
|
| Rate for Payer: Railroad Medicare Medicare |
$636.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,238.98
|
| Rate for Payer: UHC Core |
$2,124.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.08
|
| Rate for Payer: UHC Exchange |
$636.08
|
| Rate for Payer: UHC Medicare Advantage |
$636.08
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$636.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.22
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,999.24 |
| Max. Negotiated Rate |
$4,152.79 |
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,766.58
|
| Rate for Payer: BCN Commercial |
$3,565.86
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,460.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: Nomi Health Commercial |
$3,783.65
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health HMO/PPO |
$4,014.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,091.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,060.50
|
| Rate for Payer: UHC Core |
$3,852.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,460.66
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,095.87 |
| Max. Negotiated Rate |
$4,152.79 |
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: Aetna Medicare |
$1,199.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,441.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,441.94
|
| Rate for Payer: BCBS Complete |
$1,452.56
|
| Rate for Payer: BCBS MAPPO |
$1,153.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,793.34
|
| Rate for Payer: BCN Commercial |
$3,587.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,153.55
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,153.55
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,460.66
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,211.23
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,326.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: Nomi Health Commercial |
$3,783.65
|
| Rate for Payer: PACE Senior Care Partners |
$1,095.87
|
| Rate for Payer: PACE SWMI |
$1,153.55
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,153.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health HMO/PPO |
$4,014.36
|
| Rate for Payer: Priority Health Medicare |
$1,165.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,091.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,153.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,060.50
|
| Rate for Payer: UHC Core |
$3,852.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,153.55
|
| Rate for Payer: UHC Exchange |
$1,153.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,153.55
|
| Rate for Payer: UHCCP Medicaid |
$1,383.30
|
| Rate for Payer: VA VA |
$1,153.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,460.66
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$269.44 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: BCBS Trust/PPO |
$338.38
|
| Rate for Payer: BCN Commercial |
$320.35
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO |
$360.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.79
|
| Rate for Payer: UHC Core |
$346.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$98.45 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna Medicare |
$107.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.54
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: BCBS MAPPO |
$103.63
|
| Rate for Payer: BCBS Trust/PPO |
$340.79
|
| Rate for Payer: BCN Commercial |
$322.30
|
| Rate for Payer: BCN Medicare Advantage |
$103.63
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: PACE Senior Care Partners |
$98.45
|
| Rate for Payer: PACE SWMI |
$103.63
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: PHP Medicare Advantage |
$103.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO |
$360.64
|
| Rate for Payer: Priority Health Medicare |
$104.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.74
|
| Rate for Payer: Railroad Medicare Medicare |
$103.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.79
|
| Rate for Payer: UHC Core |
$346.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.63
|
| Rate for Payer: UHC Exchange |
$103.63
|
| Rate for Payer: UHC Medicare Advantage |
$103.63
|
| Rate for Payer: VA VA |
$103.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
IP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.00 |
| Max. Negotiated Rate |
$444.46 |
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: BCBS Trust/PPO |
$403.13
|
| Rate for Payer: BCN Commercial |
$381.65
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: Nomi Health Commercial |
$404.96
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health HMO/PPO |
$429.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.59
|
| Rate for Payer: UHC Core |
$412.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.39
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
OP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.29 |
| Max. Negotiated Rate |
$523.36 |
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: Aetna Medicare |
$128.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.33
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$123.46
|
| Rate for Payer: BCBS Trust/PPO |
$405.99
|
| Rate for Payer: BCN Commercial |
$383.97
|
| Rate for Payer: BCN Medicare Advantage |
$123.46
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.46
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.39
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.64
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: Nomi Health Commercial |
$404.96
|
| Rate for Payer: PACE Senior Care Partners |
$117.29
|
| Rate for Payer: PACE SWMI |
$123.46
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: PHP Medicare Advantage |
$123.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health HMO/PPO |
$429.65
|
| Rate for Payer: Priority Health Medicare |
$124.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.88
|
| Rate for Payer: Railroad Medicare Medicare |
$123.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.59
|
| Rate for Payer: UHC Core |
$412.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.46
|
| Rate for Payer: UHC Exchange |
$123.46
|
| Rate for Payer: UHC Medicare Advantage |
$123.46
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$123.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.39
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$151.89 |
| Max. Negotiated Rate |
$210.31 |
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: BCBS Trust/PPO |
$190.75
|
| Rate for Payer: BCN Commercial |
$180.59
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: Nomi Health Commercial |
$191.62
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health HMO/PPO |
$203.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.64
|
| Rate for Payer: UHC Core |
$195.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.26
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$210.31 |
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna Medicare |
$60.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.02
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$58.42
|
| Rate for Payer: BCBS Trust/PPO |
$192.11
|
| Rate for Payer: BCN Commercial |
$181.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.42
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.42
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.26
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: Nomi Health Commercial |
$191.62
|
| Rate for Payer: PACE Senior Care Partners |
$55.50
|
| Rate for Payer: PACE SWMI |
$58.42
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: PHP Medicare Advantage |
$58.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health HMO/PPO |
$203.30
|
| Rate for Payer: Priority Health Medicare |
$59.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.57
|
| Rate for Payer: Railroad Medicare Medicare |
$58.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.64
|
| Rate for Payer: UHC Core |
$195.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.42
|
| Rate for Payer: UHC Exchange |
$58.42
|
| Rate for Payer: UHC Medicare Advantage |
$58.42
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$58.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.26
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$381.27 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: Aetna Medicare |
$417.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$501.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$501.67
|
| Rate for Payer: BCBS Complete |
$642.14
|
| Rate for Payer: BCBS MAPPO |
$401.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,319.76
|
| Rate for Payer: BCN Commercial |
$1,248.16
|
| Rate for Payer: BCN Medicare Advantage |
$401.34
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.34
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: Nomi Health Commercial |
$1,316.39
|
| Rate for Payer: PACE Senior Care Partners |
$381.27
|
| Rate for Payer: PACE SWMI |
$401.34
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: PHP Medicare Advantage |
$401.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,396.65
|
| Rate for Payer: Priority Health Medicare |
$405.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.58
|
| Rate for Payer: Railroad Medicare Medicare |
$401.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,412.71
|
| Rate for Payer: UHC Core |
$1,340.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.34
|
| Rate for Payer: UHC Exchange |
$401.34
|
| Rate for Payer: UHC Medicare Advantage |
$401.34
|
| Rate for Payer: VA VA |
$401.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.01
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$1,043.48 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.45
|
| Rate for Payer: BCN Commercial |
$1,240.61
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: Nomi Health Commercial |
$1,316.39
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,396.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,412.71
|
| Rate for Payer: UHC Core |
$1,340.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.01
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.23 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: BCBS Trust/PPO |
$12,154.36
|
| Rate for Payer: BCN Commercial |
$11,506.67
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO |
$12,953.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,976.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,102.83
|
| Rate for Payer: UHC Core |
$12,432.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
OP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,536.28 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna Medicare |
$3,871.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,652.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,652.99
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$3,722.40
|
| Rate for Payer: BCBS Trust/PPO |
$12,240.72
|
| Rate for Payer: BCN Commercial |
$11,576.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,722.40
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,722.40
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,908.51
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,280.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: PACE Senior Care Partners |
$3,536.28
|
| Rate for Payer: PACE SWMI |
$3,722.40
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,722.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO |
$12,953.93
|
| Rate for Payer: Priority Health Medicare |
$3,759.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,976.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,722.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,102.83
|
| Rate for Payer: UHC Core |
$12,432.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,722.40
|
| Rate for Payer: UHC Exchange |
$3,722.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,722.40
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$3,722.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
OP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,536.28 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna Medicare |
$3,871.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,652.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,652.99
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$3,722.40
|
| Rate for Payer: BCBS Trust/PPO |
$12,240.72
|
| Rate for Payer: BCN Commercial |
$11,576.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,722.40
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,722.40
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,908.51
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,280.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: PACE Senior Care Partners |
$3,536.28
|
| Rate for Payer: PACE SWMI |
$3,722.40
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,722.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO |
$12,953.93
|
| Rate for Payer: Priority Health Medicare |
$3,759.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,976.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,722.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,102.83
|
| Rate for Payer: UHC Core |
$12,432.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,722.40
|
| Rate for Payer: UHC Exchange |
$3,722.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,722.40
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$3,722.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.23 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: BCBS Trust/PPO |
$12,154.36
|
| Rate for Payer: BCN Commercial |
$11,506.67
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$12,209.46
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO |
$12,953.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,976.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,102.83
|
| Rate for Payer: UHC Core |
$12,432.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
IP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,855.54 |
| Max. Negotiated Rate |
$10,876.90 |
| Rate for Payer: Aetna Commercial |
$10,272.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,865.34
|
| Rate for Payer: BCN Commercial |
$9,339.63
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$10,393.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Healthscope Commercial |
$10,876.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,064.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: Nomi Health Commercial |
$9,910.06
|
| Rate for Payer: PHP Commercial |
$10,272.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: Priority Health HMO/PPO |
$10,514.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,097.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,635.19
|
| Rate for Payer: UHC Core |
$10,091.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,064.08
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
OP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,870.29 |
| Max. Negotiated Rate |
$13,357.09 |
| Rate for Payer: Aetna Commercial |
$10,272.62
|
| Rate for Payer: Aetna Medicare |
$3,142.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,776.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,776.70
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$3,021.36
|
| Rate for Payer: BCBS Trust/PPO |
$9,935.44
|
| Rate for Payer: BCN Commercial |
$9,396.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,021.36
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$10,393.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,021.36
|
| Rate for Payer: Healthscope Commercial |
$10,876.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,064.08
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,172.43
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,474.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: Nomi Health Commercial |
$9,910.06
|
| Rate for Payer: PACE Senior Care Partners |
$2,870.29
|
| Rate for Payer: PACE SWMI |
$3,021.36
|
| Rate for Payer: PHP Commercial |
$10,272.62
|
| Rate for Payer: PHP Medicare Advantage |
$3,021.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: Priority Health HMO/PPO |
$10,514.33
|
| Rate for Payer: Priority Health Medicare |
$3,051.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,097.24
|
| Rate for Payer: Railroad Medicare Medicare |
$3,021.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,635.19
|
| Rate for Payer: UHC Core |
$10,091.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,021.36
|
| Rate for Payer: UHC Exchange |
$3,021.36
|
| Rate for Payer: UHC Medicare Advantage |
$3,021.36
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$3,021.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,064.08
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,430.82 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: BCBS Trust/PPO |
$10,587.81
|
| Rate for Payer: BCN Commercial |
$10,023.59
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$11,154.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health HMO/PPO |
$11,284.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,690.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,414.03
|
| Rate for Payer: UHC Core |
$10,830.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
