|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,342.04 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.39
|
| Rate for Payer: BCN Commercial |
$1,595.58
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,796.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.91
|
| Rate for Payer: UHC Core |
$1,724.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$576.89 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna Medicare |
$631.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.07
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$607.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,996.91
|
| Rate for Payer: BCN Commercial |
$1,888.57
|
| Rate for Payer: BCN Medicare Advantage |
$607.26
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.26
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.62
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PACE Senior Care Partners |
$576.89
|
| Rate for Payer: PACE SWMI |
$607.26
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: PHP Medicare Advantage |
$607.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,113.26
|
| Rate for Payer: Priority Health Medicare |
$613.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,627.45
|
| Rate for Payer: Railroad Medicare Medicare |
$607.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,137.55
|
| Rate for Payer: UHC Core |
$2,028.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.26
|
| Rate for Payer: UHC Exchange |
$607.26
|
| Rate for Payer: UHC Medicare Advantage |
$607.26
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$607.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,578.87 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.82
|
| Rate for Payer: BCN Commercial |
$1,877.15
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,113.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,627.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,137.55
|
| Rate for Payer: UHC Core |
$2,028.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.02 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: BCBS Trust/PPO |
$136.92
|
| Rate for Payer: BCN Commercial |
$129.62
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO |
$145.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.60
|
| Rate for Payer: UHC Core |
$140.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.84 |
| Max. Negotiated Rate |
$607.65 |
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: Aetna Medicare |
$43.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.42
|
| Rate for Payer: BCBS Complete |
$607.65
|
| Rate for Payer: BCBS MAPPO |
$41.93
|
| Rate for Payer: BCBS Trust/PPO |
$137.89
|
| Rate for Payer: BCN Commercial |
$130.41
|
| Rate for Payer: BCN Medicare Advantage |
$41.93
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.93
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Mclaren Medicaid |
$578.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.03
|
| Rate for Payer: Meridian Medicaid |
$607.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE Senior Care Partners |
$39.84
|
| Rate for Payer: PACE SWMI |
$41.93
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: PHP Medicare Advantage |
$41.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO |
$145.93
|
| Rate for Payer: Priority Health Medicare |
$42.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.38
|
| Rate for Payer: Railroad Medicare Medicare |
$41.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.60
|
| Rate for Payer: UHC Core |
$140.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.93
|
| Rate for Payer: UHC Exchange |
$41.93
|
| Rate for Payer: UHC Medicare Advantage |
$41.93
|
| Rate for Payer: UHCCP Medicaid |
$578.67
|
| Rate for Payer: VA VA |
$41.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.19 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: Aetna Medicare |
$38.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.30
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$37.04
|
| Rate for Payer: BCBS Trust/PPO |
$121.81
|
| Rate for Payer: BCN Commercial |
$115.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.04
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.04
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: PACE Senior Care Partners |
$35.19
|
| Rate for Payer: PACE SWMI |
$37.04
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: PHP Medicare Advantage |
$37.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO |
$128.91
|
| Rate for Payer: Priority Health Medicare |
$37.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.39
|
| Rate for Payer: UHC Core |
$123.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.04
|
| Rate for Payer: UHC Exchange |
$37.04
|
| Rate for Payer: UHC Medicare Advantage |
$37.04
|
| Rate for Payer: VA VA |
$37.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: BCBS Trust/PPO |
$120.95
|
| Rate for Payer: BCN Commercial |
$114.51
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO |
$128.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.39
|
| Rate for Payer: UHC Core |
$123.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: BCBS Trust/PPO |
$39.84
|
| Rate for Payer: BCN Commercial |
$37.71
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health HMO/PPO |
$42.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Core |
$40.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: Aetna Medicare |
$12.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.25
|
| Rate for Payer: BCBS Complete |
$19.52
|
| Rate for Payer: BCBS MAPPO |
$12.20
|
| Rate for Payer: BCBS Trust/PPO |
$40.12
|
| Rate for Payer: BCN Commercial |
$37.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.20
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.20
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.59
|
| Rate for Payer: PACE SWMI |
$12.20
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health HMO/PPO |
$42.46
|
| Rate for Payer: Priority Health Medicare |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Core |
$40.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.20
|
| Rate for Payer: UHC Exchange |
$12.20
|
| Rate for Payer: UHC Medicare Advantage |
$12.20
|
| Rate for Payer: VA VA |
$12.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$17,109.38 |
| Max. Negotiated Rate |
$23,689.91 |
| Rate for Payer: Aetna Commercial |
$22,373.80
|
| Rate for Payer: BCBS Trust/PPO |
$21,486.75
|
| Rate for Payer: BCN Commercial |
$20,341.73
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$22,637.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Healthscope Commercial |
$23,689.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,741.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: Nomi Health Commercial |
$21,584.14
|
| Rate for Payer: PHP Commercial |
$22,373.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: Priority Health HMO/PPO |
$22,900.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,635.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,163.47
|
| Rate for Payer: UHC Core |
$21,978.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,741.59
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,251.50 |
| Max. Negotiated Rate |
$23,689.91 |
| Rate for Payer: Aetna Commercial |
$22,373.80
|
| Rate for Payer: Aetna Medicare |
$6,843.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,225.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,225.66
|
| Rate for Payer: BCBS Complete |
$10,528.85
|
| Rate for Payer: BCBS MAPPO |
$6,580.53
|
| Rate for Payer: BCBS Trust/PPO |
$21,639.41
|
| Rate for Payer: BCN Commercial |
$20,465.45
|
| Rate for Payer: BCN Medicare Advantage |
$6,580.53
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$22,637.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,580.53
|
| Rate for Payer: Healthscope Commercial |
$23,689.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,741.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,909.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,567.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: Nomi Health Commercial |
$21,584.14
|
| Rate for Payer: PACE Senior Care Partners |
$6,251.50
|
| Rate for Payer: PACE SWMI |
$6,580.53
|
| Rate for Payer: PHP Commercial |
$22,373.80
|
| Rate for Payer: PHP Medicare Advantage |
$6,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: Priority Health HMO/PPO |
$22,900.24
|
| Rate for Payer: Priority Health Medicare |
$6,646.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,635.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6,580.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,163.47
|
| Rate for Payer: UHC Core |
$21,978.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,580.53
|
| Rate for Payer: UHC Exchange |
$6,580.53
|
| Rate for Payer: UHC Medicare Advantage |
$6,580.53
|
| Rate for Payer: VA VA |
$6,580.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,741.59
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,476.43 |
| Max. Negotiated Rate |
$6,198.13 |
| Rate for Payer: Aetna Commercial |
$5,853.79
|
| Rate for Payer: BCBS Trust/PPO |
$5,621.70
|
| Rate for Payer: BCN Commercial |
$5,322.13
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$5,922.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Healthscope Commercial |
$6,198.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,165.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: Nomi Health Commercial |
$5,647.18
|
| Rate for Payer: PHP Commercial |
$5,853.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: Priority Health HMO/PPO |
$5,991.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,614.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,060.39
|
| Rate for Payer: UHC Core |
$5,750.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,165.11
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,635.62 |
| Max. Negotiated Rate |
$6,198.13 |
| Rate for Payer: Aetna Commercial |
$5,853.79
|
| Rate for Payer: Aetna Medicare |
$1,790.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,152.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,152.13
|
| Rate for Payer: BCBS Complete |
$2,754.72
|
| Rate for Payer: BCBS MAPPO |
$1,721.70
|
| Rate for Payer: BCBS Trust/PPO |
$5,661.65
|
| Rate for Payer: BCN Commercial |
$5,354.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,721.70
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$5,922.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,721.70
|
| Rate for Payer: Healthscope Commercial |
$6,198.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,165.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,807.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,979.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: Nomi Health Commercial |
$5,647.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,635.62
|
| Rate for Payer: PACE SWMI |
$1,721.70
|
| Rate for Payer: PHP Commercial |
$5,853.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,721.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: Priority Health HMO/PPO |
$5,991.52
|
| Rate for Payer: Priority Health Medicare |
$1,738.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,614.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,721.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,060.39
|
| Rate for Payer: UHC Core |
$5,750.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,721.70
|
| Rate for Payer: UHC Exchange |
$1,721.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,721.70
|
| Rate for Payer: VA VA |
$1,721.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,165.11
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,036.06 |
| Max. Negotiated Rate |
$7,715.61 |
| Rate for Payer: Aetna Commercial |
$7,286.96
|
| Rate for Payer: Aetna Medicare |
$2,228.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,679.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,679.03
|
| Rate for Payer: BCBS Complete |
$3,429.16
|
| Rate for Payer: BCBS MAPPO |
$2,143.22
|
| Rate for Payer: BCBS Trust/PPO |
$7,047.78
|
| Rate for Payer: BCN Commercial |
$6,665.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,143.22
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$7,372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,143.22
|
| Rate for Payer: Healthscope Commercial |
$7,715.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,429.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,250.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,464.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: PACE Senior Care Partners |
$2,036.06
|
| Rate for Payer: PACE SWMI |
$2,143.22
|
| Rate for Payer: PHP Commercial |
$7,286.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,143.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: Priority Health HMO/PPO |
$7,458.42
|
| Rate for Payer: Priority Health Medicare |
$2,164.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,743.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,143.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,544.15
|
| Rate for Payer: UHC Core |
$7,158.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,143.22
|
| Rate for Payer: UHC Exchange |
$2,143.22
|
| Rate for Payer: UHC Medicare Advantage |
$2,143.22
|
| Rate for Payer: VA VA |
$2,143.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,429.68
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,572.38 |
| Max. Negotiated Rate |
$7,715.61 |
| Rate for Payer: Aetna Commercial |
$7,286.96
|
| Rate for Payer: BCBS Trust/PPO |
$6,998.06
|
| Rate for Payer: BCN Commercial |
$6,625.14
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$7,372.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Healthscope Commercial |
$7,715.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,429.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: PHP Commercial |
$7,286.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: Priority Health HMO/PPO |
$7,458.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,743.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,544.15
|
| Rate for Payer: UHC Core |
$7,158.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,429.68
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,398.29 |
| Max. Negotiated Rate |
$16,667.21 |
| Rate for Payer: Aetna Commercial |
$15,741.25
|
| Rate for Payer: Aetna Medicare |
$4,814.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,787.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,787.22
|
| Rate for Payer: BCBS Complete |
$7,407.65
|
| Rate for Payer: BCBS MAPPO |
$4,629.78
|
| Rate for Payer: BCBS Trust/PPO |
$15,224.57
|
| Rate for Payer: BCN Commercial |
$14,398.62
|
| Rate for Payer: BCN Medicare Advantage |
$4,629.78
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$15,926.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,629.78
|
| Rate for Payer: Healthscope Commercial |
$16,667.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,889.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,861.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,324.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: Nomi Health Commercial |
$15,185.68
|
| Rate for Payer: PACE Senior Care Partners |
$4,398.29
|
| Rate for Payer: PACE SWMI |
$4,629.78
|
| Rate for Payer: PHP Commercial |
$15,741.25
|
| Rate for Payer: PHP Medicare Advantage |
$4,629.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: Priority Health HMO/PPO |
$16,111.63
|
| Rate for Payer: Priority Health Medicare |
$4,676.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,407.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4,629.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,296.83
|
| Rate for Payer: UHC Core |
$15,463.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,629.78
|
| Rate for Payer: UHC Exchange |
$4,629.78
|
| Rate for Payer: UHC Medicare Advantage |
$4,629.78
|
| Rate for Payer: VA VA |
$4,629.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,889.34
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,037.43 |
| Max. Negotiated Rate |
$16,667.21 |
| Rate for Payer: Aetna Commercial |
$15,741.25
|
| Rate for Payer: BCBS Trust/PPO |
$15,117.16
|
| Rate for Payer: BCN Commercial |
$14,311.58
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$15,926.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Healthscope Commercial |
$16,667.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,889.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: Nomi Health Commercial |
$15,185.68
|
| Rate for Payer: PHP Commercial |
$15,741.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: Priority Health HMO/PPO |
$16,111.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,407.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,296.83
|
| Rate for Payer: UHC Core |
$15,463.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,889.34
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14,336.71 |
| Max. Negotiated Rate |
$19,850.83 |
| Rate for Payer: Aetna Commercial |
$18,748.01
|
| Rate for Payer: BCBS Trust/PPO |
$18,004.70
|
| Rate for Payer: BCN Commercial |
$17,045.25
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$18,968.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Healthscope Commercial |
$19,850.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,542.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: Nomi Health Commercial |
$18,086.31
|
| Rate for Payer: PHP Commercial |
$18,748.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: Priority Health HMO/PPO |
$19,189.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,777.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,409.70
|
| Rate for Payer: UHC Core |
$18,417.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,542.36
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,238.41 |
| Max. Negotiated Rate |
$19,850.83 |
| Rate for Payer: Aetna Commercial |
$18,748.01
|
| Rate for Payer: Aetna Medicare |
$5,734.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,892.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,892.65
|
| Rate for Payer: BCBS Complete |
$8,822.59
|
| Rate for Payer: BCBS MAPPO |
$5,514.12
|
| Rate for Payer: BCBS Trust/PPO |
$18,132.63
|
| Rate for Payer: BCN Commercial |
$17,148.91
|
| Rate for Payer: BCN Medicare Advantage |
$5,514.12
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$18,968.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,514.12
|
| Rate for Payer: Healthscope Commercial |
$19,850.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,542.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,789.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,341.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: Nomi Health Commercial |
$18,086.31
|
| Rate for Payer: PACE Senior Care Partners |
$5,238.41
|
| Rate for Payer: PACE SWMI |
$5,514.12
|
| Rate for Payer: PHP Commercial |
$18,748.01
|
| Rate for Payer: PHP Medicare Advantage |
$5,514.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: Priority Health HMO/PPO |
$19,189.14
|
| Rate for Payer: Priority Health Medicare |
$5,569.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,777.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,514.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,409.70
|
| Rate for Payer: UHC Core |
$18,417.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,514.12
|
| Rate for Payer: UHC Exchange |
$5,514.12
|
| Rate for Payer: UHC Medicare Advantage |
$5,514.12
|
| Rate for Payer: VA VA |
$5,514.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,542.36
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,467.54 |
| Max. Negotiated Rate |
$2,031.98 |
| Rate for Payer: Aetna Commercial |
$1,919.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,843.01
|
| Rate for Payer: BCN Commercial |
$1,744.80
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$1,941.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Healthscope Commercial |
$2,031.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,693.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: Nomi Health Commercial |
$1,851.36
|
| Rate for Payer: PHP Commercial |
$1,919.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,964.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,512.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,986.83
|
| Rate for Payer: UHC Core |
$1,885.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,693.32
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$536.22 |
| Max. Negotiated Rate |
$2,031.98 |
| Rate for Payer: Aetna Commercial |
$1,919.10
|
| Rate for Payer: Aetna Medicare |
$587.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$705.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$705.55
|
| Rate for Payer: BCBS Complete |
$903.10
|
| Rate for Payer: BCBS MAPPO |
$564.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,856.10
|
| Rate for Payer: BCN Commercial |
$1,755.41
|
| Rate for Payer: BCN Medicare Advantage |
$564.44
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$1,941.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.44
|
| Rate for Payer: Healthscope Commercial |
$2,031.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,693.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$649.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: Nomi Health Commercial |
$1,851.36
|
| Rate for Payer: PACE Senior Care Partners |
$536.22
|
| Rate for Payer: PACE SWMI |
$564.44
|
| Rate for Payer: PHP Commercial |
$1,919.10
|
| Rate for Payer: PHP Medicare Advantage |
$564.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,964.25
|
| Rate for Payer: Priority Health Medicare |
$570.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,512.70
|
| Rate for Payer: Railroad Medicare Medicare |
$564.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,986.83
|
| Rate for Payer: UHC Core |
$1,885.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.44
|
| Rate for Payer: UHC Exchange |
$564.44
|
| Rate for Payer: UHC Medicare Advantage |
$564.44
|
| Rate for Payer: VA VA |
$564.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,693.32
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,247.19 |
| Max. Negotiated Rate |
$12,803.80 |
| Rate for Payer: Aetna Commercial |
$12,092.47
|
| Rate for Payer: BCBS Trust/PPO |
$11,613.04
|
| Rate for Payer: BCN Commercial |
$10,994.19
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$12,234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Healthscope Commercial |
$12,803.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,669.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: Nomi Health Commercial |
$11,665.68
|
| Rate for Payer: PHP Commercial |
$12,092.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: Priority Health HMO/PPO |
$12,377.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,531.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,519.27
|
| Rate for Payer: UHC Core |
$11,879.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,669.83
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,378.78 |
| Max. Negotiated Rate |
$12,803.80 |
| Rate for Payer: Aetna Commercial |
$12,092.47
|
| Rate for Payer: Aetna Medicare |
$3,698.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,445.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,445.76
|
| Rate for Payer: BCBS Complete |
$5,690.58
|
| Rate for Payer: BCBS MAPPO |
$3,556.61
|
| Rate for Payer: BCBS Trust/PPO |
$11,695.56
|
| Rate for Payer: BCN Commercial |
$11,061.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,556.61
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$12,234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,556.61
|
| Rate for Payer: Healthscope Commercial |
$12,803.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,669.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,734.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,090.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: Nomi Health Commercial |
$11,665.68
|
| Rate for Payer: PACE Senior Care Partners |
$3,378.78
|
| Rate for Payer: PACE SWMI |
$3,556.61
|
| Rate for Payer: PHP Commercial |
$12,092.47
|
| Rate for Payer: PHP Medicare Advantage |
$3,556.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: Priority Health HMO/PPO |
$12,377.00
|
| Rate for Payer: Priority Health Medicare |
$3,592.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,531.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,556.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,519.27
|
| Rate for Payer: UHC Core |
$11,879.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,556.61
|
| Rate for Payer: UHC Exchange |
$3,556.61
|
| Rate for Payer: UHC Medicare Advantage |
$3,556.61
|
| Rate for Payer: VA VA |
$3,556.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,669.83
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,083.59 |
| Max. Negotiated Rate |
$7,895.70 |
| Rate for Payer: Aetna Commercial |
$7,457.05
|
| Rate for Payer: Aetna Medicare |
$2,280.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,741.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,741.56
|
| Rate for Payer: BCBS Complete |
$3,509.20
|
| Rate for Payer: BCBS MAPPO |
$2,193.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,212.28
|
| Rate for Payer: BCN Commercial |
$6,821.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,193.25
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$7,544.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,193.25
|
| Rate for Payer: Healthscope Commercial |
$7,895.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,579.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,302.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,522.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: Nomi Health Commercial |
$7,193.86
|
| Rate for Payer: PACE Senior Care Partners |
$2,083.59
|
| Rate for Payer: PACE SWMI |
$2,193.25
|
| Rate for Payer: PHP Commercial |
$7,457.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,193.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: Priority Health HMO/PPO |
$7,632.51
|
| Rate for Payer: Priority Health Medicare |
$2,215.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,877.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,193.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,720.24
|
| Rate for Payer: UHC Core |
$7,325.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,193.25
|
| Rate for Payer: UHC Exchange |
$2,193.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,193.25
|
| Rate for Payer: VA VA |
$2,193.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,579.75
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,702.45 |
| Max. Negotiated Rate |
$7,895.70 |
| Rate for Payer: Aetna Commercial |
$7,457.05
|
| Rate for Payer: BCBS Trust/PPO |
$7,161.40
|
| Rate for Payer: BCN Commercial |
$6,779.77
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$7,544.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Healthscope Commercial |
$7,895.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,579.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: Nomi Health Commercial |
$7,193.86
|
| Rate for Payer: PHP Commercial |
$7,457.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: Priority Health HMO/PPO |
$7,632.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,877.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,720.24
|
| Rate for Payer: UHC Core |
$7,325.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,579.75
|
|
