|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
IP
|
$13,091.70
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,984.63 |
| Max. Negotiated Rate |
$11,782.53 |
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: BCBS Trust/PPO |
$10,117.27
|
| Rate for Payer: BCN Commercial |
$10,117.27
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,389.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,984.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,520.70
|
| Rate for Payer: UHC Core |
$10,931.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
OP
|
$708.90
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$638.01 |
| Rate for Payer: Aetna Commercial |
$602.56
|
| Rate for Payer: Aetna Medicare |
$184.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.53
|
| Rate for Payer: BCBS Complete |
$283.56
|
| Rate for Payer: BCBS MAPPO |
$177.22
|
| Rate for Payer: BCBS Trust/PPO |
$551.17
|
| Rate for Payer: BCCCP Commercial |
$53.05
|
| Rate for Payer: BCN Commercial |
$551.17
|
| Rate for Payer: BCN Medicare Advantage |
$177.22
|
| Rate for Payer: Cash Price |
$567.12
|
| Rate for Payer: Cash Price |
$567.12
|
| Rate for Payer: Cofinity Commercial |
$609.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$567.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.22
|
| Rate for Payer: Healthscope Commercial |
$638.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$531.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$602.56
|
| Rate for Payer: PACE Senior Care Partners |
$168.36
|
| Rate for Payer: PACE SWMI |
$177.22
|
| Rate for Payer: PHP Commercial |
$602.56
|
| Rate for Payer: PHP Medicare Advantage |
$177.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$616.74
|
| Rate for Payer: Priority Health Medicare |
$177.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.36
|
| Rate for Payer: Railroad Medicare Medicare |
$177.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.83
|
| Rate for Payer: UHC Core |
$591.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.22
|
| Rate for Payer: UHC Medicare Advantage |
$182.54
|
| Rate for Payer: VA VA |
$177.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$531.68
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
IP
|
$708.90
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$432.36 |
| Max. Negotiated Rate |
$638.01 |
| Rate for Payer: Aetna Commercial |
$602.56
|
| Rate for Payer: BCBS Trust/PPO |
$547.84
|
| Rate for Payer: BCN Commercial |
$547.84
|
| Rate for Payer: Cash Price |
$567.12
|
| Rate for Payer: Cofinity Commercial |
$609.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$567.12
|
| Rate for Payer: Healthscope Commercial |
$638.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$531.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$602.56
|
| Rate for Payer: PHP Commercial |
$602.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$616.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.83
|
| Rate for Payer: UHC Core |
$591.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$531.68
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
OP
|
$215.22
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$51.11 |
| Max. Negotiated Rate |
$193.70 |
| Rate for Payer: Aetna Commercial |
$182.94
|
| Rate for Payer: Aetna Medicare |
$55.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.26
|
| Rate for Payer: BCBS Complete |
$137.25
|
| Rate for Payer: BCBS MAPPO |
$53.80
|
| Rate for Payer: BCBS Trust/PPO |
$167.33
|
| Rate for Payer: BCCCP Commercial |
$107.56
|
| Rate for Payer: BCN Commercial |
$167.33
|
| Rate for Payer: BCN Medicare Advantage |
$53.80
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cofinity Commercial |
$185.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.80
|
| Rate for Payer: Healthscope Commercial |
$193.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.42
|
| Rate for Payer: Mclaren Medicaid |
$130.71
|
| Rate for Payer: Meridian Medicaid |
$137.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.94
|
| Rate for Payer: PACE Senior Care Partners |
$51.11
|
| Rate for Payer: PACE SWMI |
$53.80
|
| Rate for Payer: PHP Commercial |
$182.94
|
| Rate for Payer: PHP Medicare Advantage |
$53.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.24
|
| Rate for Payer: Priority Health Medicare |
$53.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.26
|
| Rate for Payer: Railroad Medicare Medicare |
$53.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.39
|
| Rate for Payer: UHC Core |
$179.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.80
|
| Rate for Payer: UHC Medicare Advantage |
$55.42
|
| Rate for Payer: VA VA |
$53.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.42
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
IP
|
$215.22
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.26 |
| Max. Negotiated Rate |
$193.70 |
| Rate for Payer: Aetna Commercial |
$182.94
|
| Rate for Payer: BCBS Trust/PPO |
$166.32
|
| Rate for Payer: BCN Commercial |
$166.32
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cofinity Commercial |
$185.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.18
|
| Rate for Payer: Healthscope Commercial |
$193.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.94
|
| Rate for Payer: PHP Commercial |
$182.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.39
|
| Rate for Payer: UHC Core |
$179.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.42
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
IP
|
$2,809.61
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,713.58 |
| Max. Negotiated Rate |
$2,528.65 |
| Rate for Payer: Aetna Commercial |
$2,388.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,171.27
|
| Rate for Payer: BCN Commercial |
$2,171.27
|
| Rate for Payer: Cash Price |
$2,247.69
|
| Rate for Payer: Cofinity Commercial |
$2,416.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,247.69
|
| Rate for Payer: Healthscope Commercial |
$2,528.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,107.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,388.17
|
| Rate for Payer: PHP Commercial |
$2,388.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,966.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,444.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,713.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,472.46
|
| Rate for Payer: UHC Core |
$2,346.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,107.21
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
OP
|
$2,809.61
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$667.28 |
| Max. Negotiated Rate |
$2,528.65 |
| Rate for Payer: Aetna Commercial |
$2,388.17
|
| Rate for Payer: Aetna Medicare |
$730.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$878.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$878.00
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$702.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,184.47
|
| Rate for Payer: BCN Commercial |
$2,184.47
|
| Rate for Payer: BCN Medicare Advantage |
$702.40
|
| Rate for Payer: Cash Price |
$2,247.69
|
| Rate for Payer: Cash Price |
$2,247.69
|
| Rate for Payer: Cofinity Commercial |
$2,416.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,247.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.40
|
| Rate for Payer: Healthscope Commercial |
$2,528.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,107.21
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$737.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$807.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,388.17
|
| Rate for Payer: PACE Senior Care Partners |
$667.28
|
| Rate for Payer: PACE SWMI |
$702.40
|
| Rate for Payer: PHP Commercial |
$2,388.17
|
| Rate for Payer: PHP Medicare Advantage |
$702.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,966.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,444.36
|
| Rate for Payer: Priority Health Medicare |
$702.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,713.58
|
| Rate for Payer: Railroad Medicare Medicare |
$702.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,472.46
|
| Rate for Payer: UHC Core |
$2,346.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$702.40
|
| Rate for Payer: UHC Medicare Advantage |
$723.47
|
| Rate for Payer: VA VA |
$702.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,107.21
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
IP
|
$78.54
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: BCBS Trust/PPO |
$60.70
|
| Rate for Payer: BCN Commercial |
$60.70
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.76
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.90
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
OP
|
$78.54
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$19.64
|
| Rate for Payer: BCBS Trust/PPO |
$61.06
|
| Rate for Payer: BCN Commercial |
$61.06
|
| Rate for Payer: BCN Medicare Advantage |
$19.64
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.64
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.90
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.76
|
| Rate for Payer: PACE Senior Care Partners |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.64
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: PHP Medicare Advantage |
$19.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.33
|
| Rate for Payer: Priority Health Medicare |
$19.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.90
|
| Rate for Payer: Railroad Medicare Medicare |
$19.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$20.22
|
| Rate for Payer: VA VA |
$19.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.90
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
OP
|
$156.90
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$141.21 |
| Rate for Payer: Aetna Commercial |
$133.36
|
| Rate for Payer: Aetna Medicare |
$40.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.03
|
| Rate for Payer: BCBS Complete |
$9.37
|
| Rate for Payer: BCBS MAPPO |
$39.22
|
| Rate for Payer: BCBS Trust/PPO |
$121.99
|
| Rate for Payer: BCN Commercial |
$121.99
|
| Rate for Payer: BCN Medicare Advantage |
$39.22
|
| Rate for Payer: Cash Price |
$125.52
|
| Rate for Payer: Cash Price |
$125.52
|
| Rate for Payer: Cofinity Commercial |
$134.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.22
|
| Rate for Payer: Healthscope Commercial |
$141.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.68
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Meridian Medicaid |
$9.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.36
|
| Rate for Payer: PACE Senior Care Partners |
$37.26
|
| Rate for Payer: PACE SWMI |
$39.22
|
| Rate for Payer: PHP Commercial |
$133.36
|
| Rate for Payer: PHP Medicare Advantage |
$39.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.50
|
| Rate for Payer: Priority Health Medicare |
$39.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.69
|
| Rate for Payer: Railroad Medicare Medicare |
$39.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.07
|
| Rate for Payer: UHC Core |
$131.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.22
|
| Rate for Payer: UHC Medicare Advantage |
$40.40
|
| Rate for Payer: VA VA |
$39.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.68
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
IP
|
$156.90
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$95.69 |
| Max. Negotiated Rate |
$141.21 |
| Rate for Payer: Aetna Commercial |
$133.36
|
| Rate for Payer: BCBS Trust/PPO |
$121.25
|
| Rate for Payer: BCN Commercial |
$121.25
|
| Rate for Payer: Cash Price |
$125.52
|
| Rate for Payer: Cofinity Commercial |
$134.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.52
|
| Rate for Payer: Healthscope Commercial |
$141.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.36
|
| Rate for Payer: PHP Commercial |
$133.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.07
|
| Rate for Payer: UHC Core |
$131.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.68
|
|
|
HC ENDOPLEGE
|
Facility
|
OP
|
$5,194.83
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,233.77 |
| Max. Negotiated Rate |
$4,675.35 |
| Rate for Payer: Aetna Commercial |
$4,415.61
|
| Rate for Payer: Aetna Medicare |
$1,350.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,623.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,623.38
|
| Rate for Payer: BCBS Complete |
$2,077.93
|
| Rate for Payer: BCBS MAPPO |
$1,298.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,038.98
|
| Rate for Payer: BCN Commercial |
$4,038.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,298.71
|
| Rate for Payer: Cash Price |
$4,155.86
|
| Rate for Payer: Cofinity Commercial |
$4,467.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,155.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,298.71
|
| Rate for Payer: Healthscope Commercial |
$4,675.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,896.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,363.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,493.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,415.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,233.77
|
| Rate for Payer: PACE SWMI |
$1,298.71
|
| Rate for Payer: PHP Commercial |
$4,415.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,298.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,636.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,519.50
|
| Rate for Payer: Priority Health Medicare |
$1,298.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,168.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,298.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,571.45
|
| Rate for Payer: UHC Core |
$4,337.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,298.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,337.67
|
| Rate for Payer: VA VA |
$1,298.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,896.12
|
|
|
HC ENDOPLEGE
|
Facility
|
IP
|
$5,194.83
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,168.33 |
| Max. Negotiated Rate |
$4,675.35 |
| Rate for Payer: Aetna Commercial |
$4,415.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,014.56
|
| Rate for Payer: BCN Commercial |
$4,014.56
|
| Rate for Payer: Cash Price |
$4,155.86
|
| Rate for Payer: Cofinity Commercial |
$4,467.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,155.86
|
| Rate for Payer: Healthscope Commercial |
$4,675.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,896.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,415.61
|
| Rate for Payer: PHP Commercial |
$4,415.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,636.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,519.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,168.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,571.45
|
| Rate for Payer: UHC Core |
$4,337.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,896.12
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
OP
|
$9,288.24
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,205.96 |
| Max. Negotiated Rate |
$8,359.42 |
| Rate for Payer: Aetna Commercial |
$7,895.00
|
| Rate for Payer: Aetna Medicare |
$2,414.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,902.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,902.58
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$2,322.06
|
| Rate for Payer: BCBS Trust/PPO |
$7,221.61
|
| Rate for Payer: BCN Commercial |
$7,221.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,322.06
|
| Rate for Payer: Cash Price |
$7,430.59
|
| Rate for Payer: Cash Price |
$7,430.59
|
| Rate for Payer: Cofinity Commercial |
$7,987.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,430.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,322.06
|
| Rate for Payer: Healthscope Commercial |
$8,359.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,966.18
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,438.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,670.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,895.00
|
| Rate for Payer: PACE Senior Care Partners |
$2,205.96
|
| Rate for Payer: PACE SWMI |
$2,322.06
|
| Rate for Payer: PHP Commercial |
$7,895.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,322.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,501.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,080.77
|
| Rate for Payer: Priority Health Medicare |
$2,322.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,664.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,322.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,173.65
|
| Rate for Payer: UHC Core |
$7,755.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,322.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,391.72
|
| Rate for Payer: VA VA |
$2,322.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,966.18
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
IP
|
$9,288.24
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,664.90 |
| Max. Negotiated Rate |
$8,359.42 |
| Rate for Payer: Aetna Commercial |
$7,895.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,177.95
|
| Rate for Payer: BCN Commercial |
$7,177.95
|
| Rate for Payer: Cash Price |
$7,430.59
|
| Rate for Payer: Cofinity Commercial |
$7,987.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,430.59
|
| Rate for Payer: Healthscope Commercial |
$8,359.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,966.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,895.00
|
| Rate for Payer: PHP Commercial |
$7,895.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,501.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,080.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,664.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,173.65
|
| Rate for Payer: UHC Core |
$7,755.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,966.18
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.90 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: BCBS Trust/PPO |
$382.54
|
| Rate for Payer: BCN Commercial |
$382.54
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.60
|
| Rate for Payer: UHC Core |
$413.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.56 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna Medicare |
$128.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.69
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: BCBS MAPPO |
$123.75
|
| Rate for Payer: BCBS Trust/PPO |
$384.86
|
| Rate for Payer: BCN Commercial |
$384.86
|
| Rate for Payer: BCN Medicare Advantage |
$123.75
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.75
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$129.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.75
|
| Rate for Payer: PACE Senior Care Partners |
$117.56
|
| Rate for Payer: PACE SWMI |
$123.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: PHP Medicare Advantage |
$123.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.65
|
| Rate for Payer: Priority Health Medicare |
$123.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.90
|
| Rate for Payer: Railroad Medicare Medicare |
$123.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.60
|
| Rate for Payer: UHC Core |
$413.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.75
|
| Rate for Payer: UHC Medicare Advantage |
$127.46
|
| Rate for Payer: VA VA |
$123.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.94
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS MAPPO |
$68.75
|
| Rate for Payer: BCBS Trust/PPO |
$213.81
|
| Rate for Payer: BCN Commercial |
$213.81
|
| Rate for Payer: BCN Medicare Advantage |
$68.75
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.75
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PACE Senior Care Partners |
$65.31
|
| Rate for Payer: PACE SWMI |
$68.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: PHP Medicare Advantage |
$68.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.25
|
| Rate for Payer: Priority Health Medicare |
$68.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.72
|
| Rate for Payer: Railroad Medicare Medicare |
$68.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.00
|
| Rate for Payer: UHC Core |
$229.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.75
|
| Rate for Payer: UHC Medicare Advantage |
$70.81
|
| Rate for Payer: VA VA |
$68.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$167.72 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: BCBS Trust/PPO |
$212.52
|
| Rate for Payer: BCN Commercial |
$212.52
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.00
|
| Rate for Payer: UHC Core |
$229.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$2,717.00
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,657.10 |
| Max. Negotiated Rate |
$2,445.30 |
| Rate for Payer: Aetna Commercial |
$2,309.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,099.70
|
| Rate for Payer: BCN Commercial |
$2,099.70
|
| Rate for Payer: Cash Price |
$2,173.60
|
| Rate for Payer: Cofinity Commercial |
$2,336.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,173.60
|
| Rate for Payer: Healthscope Commercial |
$2,445.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,037.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.45
|
| Rate for Payer: PHP Commercial |
$2,309.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,363.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,657.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,390.96
|
| Rate for Payer: UHC Core |
$2,268.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,037.75
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$2,717.00
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$645.29 |
| Max. Negotiated Rate |
$2,445.30 |
| Rate for Payer: Aetna Commercial |
$2,309.45
|
| Rate for Payer: Aetna Medicare |
$706.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.06
|
| Rate for Payer: BCBS Complete |
$1,086.80
|
| Rate for Payer: BCBS MAPPO |
$679.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,112.47
|
| Rate for Payer: BCN Commercial |
$2,112.47
|
| Rate for Payer: BCN Medicare Advantage |
$679.25
|
| Rate for Payer: Cash Price |
$2,173.60
|
| Rate for Payer: Cofinity Commercial |
$2,336.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,173.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.25
|
| Rate for Payer: Healthscope Commercial |
$2,445.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,037.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$713.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,309.45
|
| Rate for Payer: PACE Senior Care Partners |
$645.29
|
| Rate for Payer: PACE SWMI |
$679.25
|
| Rate for Payer: PHP Commercial |
$2,309.45
|
| Rate for Payer: PHP Medicare Advantage |
$679.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,363.79
|
| Rate for Payer: Priority Health Medicare |
$679.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,657.10
|
| Rate for Payer: Railroad Medicare Medicare |
$679.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,390.96
|
| Rate for Payer: UHC Core |
$2,268.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.25
|
| Rate for Payer: UHC Medicare Advantage |
$699.63
|
| Rate for Payer: VA VA |
$679.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,037.75
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
OP
|
$5,002.00
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,187.98 |
| Max. Negotiated Rate |
$4,501.80 |
| Rate for Payer: Aetna Commercial |
$4,251.70
|
| Rate for Payer: Aetna Medicare |
$1,300.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,563.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,563.12
|
| Rate for Payer: BCBS Complete |
$2,000.80
|
| Rate for Payer: BCBS MAPPO |
$1,250.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,889.06
|
| Rate for Payer: BCN Commercial |
$3,889.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,250.50
|
| Rate for Payer: Cash Price |
$4,001.60
|
| Rate for Payer: Cofinity Commercial |
$4,301.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,001.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,250.50
|
| Rate for Payer: Healthscope Commercial |
$4,501.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,751.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,313.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,438.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,251.70
|
| Rate for Payer: PACE Senior Care Partners |
$1,187.98
|
| Rate for Payer: PACE SWMI |
$1,250.50
|
| Rate for Payer: PHP Commercial |
$4,251.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,250.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,501.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,351.74
|
| Rate for Payer: Priority Health Medicare |
$1,250.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,050.72
|
| Rate for Payer: Railroad Medicare Medicare |
$1,250.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,401.76
|
| Rate for Payer: UHC Core |
$4,176.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,250.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.02
|
| Rate for Payer: VA VA |
$1,250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,751.50
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
IP
|
$5,002.00
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,050.72 |
| Max. Negotiated Rate |
$4,501.80 |
| Rate for Payer: Aetna Commercial |
$4,251.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,865.55
|
| Rate for Payer: BCN Commercial |
$3,865.55
|
| Rate for Payer: Cash Price |
$4,001.60
|
| Rate for Payer: Cofinity Commercial |
$4,301.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,001.60
|
| Rate for Payer: Healthscope Commercial |
$4,501.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,751.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,251.70
|
| Rate for Payer: PHP Commercial |
$4,251.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,501.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,351.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,050.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,401.76
|
| Rate for Payer: UHC Core |
$4,176.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,751.50
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
OP
|
$773.00
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$183.59 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Aetna Commercial |
$657.05
|
| Rate for Payer: Aetna Medicare |
$200.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$241.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$241.56
|
| Rate for Payer: BCBS Complete |
$309.20
|
| Rate for Payer: BCBS MAPPO |
$193.25
|
| Rate for Payer: BCBS Trust/PPO |
$601.01
|
| Rate for Payer: BCN Commercial |
$601.01
|
| Rate for Payer: BCN Medicare Advantage |
$193.25
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$664.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.25
|
| Rate for Payer: Healthscope Commercial |
$695.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$579.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$657.05
|
| Rate for Payer: PACE Senior Care Partners |
$183.59
|
| Rate for Payer: PACE SWMI |
$193.25
|
| Rate for Payer: PHP Commercial |
$657.05
|
| Rate for Payer: PHP Medicare Advantage |
$193.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.51
|
| Rate for Payer: Priority Health Medicare |
$193.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.45
|
| Rate for Payer: Railroad Medicare Medicare |
$193.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.24
|
| Rate for Payer: UHC Core |
$645.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.25
|
| Rate for Payer: UHC Medicare Advantage |
$199.05
|
| Rate for Payer: VA VA |
$193.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$579.75
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
IP
|
$773.00
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$471.45 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Aetna Commercial |
$657.05
|
| Rate for Payer: BCBS Trust/PPO |
$597.37
|
| Rate for Payer: BCN Commercial |
$597.37
|
| Rate for Payer: Cash Price |
$618.40
|
| Rate for Payer: Cofinity Commercial |
$664.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.40
|
| Rate for Payer: Healthscope Commercial |
$695.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$579.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$657.05
|
| Rate for Payer: PHP Commercial |
$657.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$672.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.24
|
| Rate for Payer: UHC Core |
$645.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$579.75
|
|
