|
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 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 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 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 |
$534.17 |
| 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 |
$534.17
|
| 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 |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.64
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| 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 |
$508.70
|
| 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 |
$508.70
|
| 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 |
$73.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.03
|
| Rate for Payer: BCBS Complete |
$70.23
|
| 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 |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.34
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| 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 |
$66.88
|
| 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 |
$66.88
|
| 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
|
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 |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$3,722.39
|
| Rate for Payer: BCBS Trust/PPO |
$12,240.72
|
| Rate for Payer: BCN Commercial |
$11,576.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,722.39
|
| 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 |
$3,722.39
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,908.51
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| 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 |
$3,722.39
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,722.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| 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 |
$3,722.39
|
| 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 |
$3,722.39
|
| Rate for Payer: UHC Exchange |
$3,722.39
|
| Rate for Payer: UHC Medicare Advantage |
$3,722.39
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$3,722.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
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 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 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 |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$3,722.39
|
| Rate for Payer: BCBS Trust/PPO |
$12,240.72
|
| Rate for Payer: BCN Commercial |
$11,576.65
|
| Rate for Payer: BCN Medicare Advantage |
$3,722.39
|
| 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 |
$3,722.39
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,908.51
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| 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 |
$3,722.39
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,722.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| 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 |
$3,722.39
|
| 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 |
$3,722.39
|
| Rate for Payer: UHC Exchange |
$3,722.39
|
| Rate for Payer: UHC Medicare Advantage |
$3,722.39
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$3,722.39
|
| 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 |
$13,632.74 |
| 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 |
$13,632.74
|
| 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 |
$12,982.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,172.43
|
| Rate for Payer: Meridian Medicaid |
$13,632.74
|
| 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 |
$12,982.71
|
| 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 |
$12,982.71
|
| 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
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,080.49 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna Medicare |
$3,372.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,053.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,053.28
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$3,242.62
|
| Rate for Payer: BCBS Trust/PPO |
$10,663.04
|
| Rate for Payer: BCN Commercial |
$10,084.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,242.62
|
| Rate for Payer: Cash Price |
$10,376.39
|
| 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: Health Alliance Plan Medicare Advantage |
$3,242.62
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,404.75
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,729.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: PACE Senior Care Partners |
$3,080.49
|
| Rate for Payer: PACE SWMI |
$3,242.62
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,242.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| 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 Medicare |
$3,275.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,690.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,242.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,414.03
|
| Rate for Payer: UHC Core |
$10,830.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,242.62
|
| Rate for Payer: UHC Exchange |
$3,242.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,242.62
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$3,242.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
IP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
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
|
|
|
HC ATHERECT VISCERAL EACH VESS
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
36100303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,080.49 |
| Max. Negotiated Rate |
$11,673.44 |
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna Medicare |
$3,372.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,053.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,053.28
|
| Rate for Payer: BCBS Complete |
$5,188.20
|
| Rate for Payer: BCBS MAPPO |
$3,242.62
|
| Rate for Payer: BCBS Trust/PPO |
$10,663.04
|
| Rate for Payer: BCN Commercial |
$10,084.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,242.62
|
| 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: Health Alliance Plan Medicare Advantage |
$3,242.62
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,404.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,729.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$10,635.80
|
| Rate for Payer: PACE Senior Care Partners |
$3,080.49
|
| Rate for Payer: PACE SWMI |
$3,242.62
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,242.62
|
| 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 Medicare |
$3,275.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,690.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,242.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,414.03
|
| Rate for Payer: UHC Core |
$10,830.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,242.62
|
| Rate for Payer: UHC Exchange |
$3,242.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,242.62
|
| Rate for Payer: VA VA |
$3,242.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
OP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$534.48 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,912.88
|
| Rate for Payer: Aetna Medicare |
$585.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.27
|
| Rate for Payer: BCBS Complete |
$900.18
|
| Rate for Payer: BCBS MAPPO |
$562.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.09
|
| Rate for Payer: BCN Commercial |
$1,749.72
|
| Rate for Payer: BCN Medicare Advantage |
$562.61
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$1,935.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.61
|
| Rate for Payer: Healthscope Commercial |
$2,025.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: Nomi Health Commercial |
$1,845.37
|
| Rate for Payer: PACE Senior Care Partners |
$534.48
|
| Rate for Payer: PACE SWMI |
$562.61
|
| Rate for Payer: PHP Commercial |
$1,912.88
|
| Rate for Payer: PHP Medicare Advantage |
$562.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,957.89
|
| Rate for Payer: Priority Health Medicare |
$568.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,507.80
|
| Rate for Payer: Railroad Medicare Medicare |
$562.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,980.40
|
| Rate for Payer: UHC Core |
$1,879.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$562.61
|
| Rate for Payer: UHC Exchange |
$562.61
|
| Rate for Payer: UHC Medicare Advantage |
$562.61
|
| Rate for Payer: VA VA |
$562.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.84
|
|
|
HC ATS NON OPEN HEART
|
Facility
|
IP
|
$2,250.45
|
|
| Hospital Charge Code |
27000088
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,462.79 |
| Max. Negotiated Rate |
$2,025.40 |
| Rate for Payer: Aetna Commercial |
$1,912.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,837.04
|
| Rate for Payer: BCN Commercial |
$1,739.15
|
| Rate for Payer: Cash Price |
$1,800.36
|
| Rate for Payer: Cofinity Commercial |
$1,935.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.36
|
| Rate for Payer: Healthscope Commercial |
$2,025.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.88
|
| Rate for Payer: Nomi Health Commercial |
$1,845.37
|
| Rate for Payer: PHP Commercial |
$1,912.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,957.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,507.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,980.40
|
| Rate for Payer: UHC Core |
$1,879.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.84
|
|
|
HC ATS STAND BY HR
|
Facility
|
OP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$365.07 |
| Max. Negotiated Rate |
$1,383.42 |
| Rate for Payer: Aetna Commercial |
$1,306.56
|
| Rate for Payer: Aetna Medicare |
$399.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.35
|
| Rate for Payer: BCBS Complete |
$614.85
|
| Rate for Payer: BCBS MAPPO |
$384.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.67
|
| Rate for Payer: BCN Commercial |
$1,195.12
|
| Rate for Payer: BCN Medicare Advantage |
$384.28
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,321.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.28
|
| Rate for Payer: Healthscope Commercial |
$1,383.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: Nomi Health Commercial |
$1,260.45
|
| Rate for Payer: PACE Senior Care Partners |
$365.07
|
| Rate for Payer: PACE SWMI |
$384.28
|
| Rate for Payer: PHP Commercial |
$1,306.56
|
| Rate for Payer: PHP Medicare Advantage |
$384.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.30
|
| Rate for Payer: Priority Health Medicare |
$388.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.88
|
| Rate for Payer: Railroad Medicare Medicare |
$384.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.67
|
| Rate for Payer: UHC Core |
$1,283.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.28
|
| Rate for Payer: UHC Exchange |
$384.28
|
| Rate for Payer: UHC Medicare Advantage |
$384.28
|
| Rate for Payer: VA VA |
$384.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.85
|
|
|
HC ATS STAND BY HR
|
Facility
|
IP
|
$1,537.13
|
|
| Hospital Charge Code |
27000089
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$999.13 |
| Max. Negotiated Rate |
$1,383.42 |
| Rate for Payer: Aetna Commercial |
$1,306.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.76
|
| Rate for Payer: BCN Commercial |
$1,187.89
|
| Rate for Payer: Cash Price |
$1,229.70
|
| Rate for Payer: Cofinity Commercial |
$1,321.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.70
|
| Rate for Payer: Healthscope Commercial |
$1,383.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.56
|
| Rate for Payer: Nomi Health Commercial |
$1,260.45
|
| Rate for Payer: PHP Commercial |
$1,306.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.67
|
| Rate for Payer: UHC Core |
$1,283.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.85
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ATYPICAL PNEUMO EVAL C PNEUM
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$8.97
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$8.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: Meridian Medicaid |
$8.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: UHCCP Medicaid |
$8.55
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
