|
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
|
IP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,572.39 |
| Max. Negotiated Rate |
$7,715.61 |
| Rate for Payer: Aetna Commercial |
$7,286.97
|
| 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 |
$7,286.97
|
| Rate for Payer: Nomi Health Commercial |
$7,029.78
|
| Rate for Payer: PHP Commercial |
$7,286.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.39
|
| 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 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 |
$7,286.97
|
| 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 |
$7,286.97
|
| 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 |
$7,286.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,143.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.39
|
| 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 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 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 |
$5,787.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,787.23
|
| 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 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 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 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 |
$7,325.45
|
| 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 |
$7,325.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,579.75
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
OP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.97 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$52.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.11
|
| Rate for Payer: BCBS Complete |
$80.78
|
| Rate for Payer: BCBS MAPPO |
$50.49
|
| Rate for Payer: BCBS Trust/PPO |
$166.03
|
| Rate for Payer: BCN Commercial |
$157.02
|
| Rate for Payer: BCN Medicare Advantage |
$50.49
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.49
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: Nomi Health Commercial |
$165.61
|
| Rate for Payer: PACE Senior Care Partners |
$47.97
|
| Rate for Payer: PACE SWMI |
$50.49
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: PHP Medicare Advantage |
$50.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: Priority Health HMO/PPO |
$175.71
|
| Rate for Payer: Priority Health Medicare |
$50.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.31
|
| Rate for Payer: Railroad Medicare Medicare |
$50.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.72
|
| Rate for Payer: UHC Core |
$168.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.49
|
| Rate for Payer: UHC Exchange |
$50.49
|
| Rate for Payer: UHC Medicare Advantage |
$50.49
|
| Rate for Payer: VA VA |
$50.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
IP
|
$201.96
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$131.27 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: BCBS Trust/PPO |
$164.86
|
| Rate for Payer: BCN Commercial |
$156.07
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.67
|
| Rate for Payer: Nomi Health Commercial |
$165.61
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.27
|
| Rate for Payer: Priority Health HMO/PPO |
$175.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.72
|
| Rate for Payer: UHC Core |
$168.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC BOWL
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$149.18 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.07
|
| Rate for Payer: BCBS Trust/PPO |
$187.34
|
| Rate for Payer: BCN Commercial |
$177.36
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: PHP Commercial |
$195.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health HMO/PPO |
$199.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC BOWL
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.51 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.07
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.72
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS MAPPO |
$57.38
|
| Rate for Payer: BCBS Trust/PPO |
$188.67
|
| Rate for Payer: BCN Commercial |
$178.44
|
| Rate for Payer: BCN Medicare Advantage |
$57.38
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.07
|
| Rate for Payer: Nomi Health Commercial |
$188.19
|
| Rate for Payer: PACE Senior Care Partners |
$54.51
|
| Rate for Payer: PACE SWMI |
$57.38
|
| Rate for Payer: PHP Commercial |
$195.07
|
| Rate for Payer: PHP Medicare Advantage |
$57.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health HMO/PPO |
$199.66
|
| Rate for Payer: Priority Health Medicare |
$57.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.76
|
| Rate for Payer: Railroad Medicare Medicare |
$57.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.38
|
| Rate for Payer: UHC Exchange |
$57.38
|
| Rate for Payer: UHC Medicare Advantage |
$57.38
|
| Rate for Payer: VA VA |
$57.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$164.76 |
| Max. Negotiated Rate |
$228.12 |
| Rate for Payer: Aetna Commercial |
$215.45
|
| Rate for Payer: BCBS Trust/PPO |
$206.91
|
| Rate for Payer: BCN Commercial |
$195.88
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$217.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Healthscope Commercial |
$228.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: Nomi Health Commercial |
$207.85
|
| Rate for Payer: PHP Commercial |
$215.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health HMO/PPO |
$220.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.05
|
| Rate for Payer: UHC Core |
$211.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.10
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$253.47
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$228.12 |
| Rate for Payer: Aetna Commercial |
$215.45
|
| Rate for Payer: Aetna Medicare |
$65.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.21
|
| Rate for Payer: BCBS Complete |
$101.39
|
| Rate for Payer: BCBS MAPPO |
$63.37
|
| Rate for Payer: BCBS Trust/PPO |
$208.38
|
| Rate for Payer: BCN Commercial |
$197.07
|
| Rate for Payer: BCN Medicare Advantage |
$63.37
|
| Rate for Payer: Cash Price |
$202.78
|
| Rate for Payer: Cofinity Commercial |
$217.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.37
|
| Rate for Payer: Healthscope Commercial |
$228.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.45
|
| Rate for Payer: Nomi Health Commercial |
$207.85
|
| Rate for Payer: PACE Senior Care Partners |
$60.20
|
| Rate for Payer: PACE SWMI |
$63.37
|
| Rate for Payer: PHP Commercial |
$215.45
|
| Rate for Payer: PHP Medicare Advantage |
$63.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.76
|
| Rate for Payer: Priority Health HMO/PPO |
$220.52
|
| Rate for Payer: Priority Health Medicare |
$64.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.82
|
| Rate for Payer: Railroad Medicare Medicare |
$63.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.05
|
| Rate for Payer: UHC Core |
$211.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.37
|
| Rate for Payer: UHC Exchange |
$63.37
|
| Rate for Payer: UHC Medicare Advantage |
$63.37
|
| Rate for Payer: VA VA |
$63.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.10
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
OP
|
$52.44
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$47.20 |
| Rate for Payer: Aetna Commercial |
$44.57
|
| Rate for Payer: Aetna Medicare |
$13.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.39
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.11
|
| Rate for Payer: BCBS Trust/PPO |
$43.11
|
| Rate for Payer: BCN Commercial |
$40.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.11
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cash Price |
$41.95
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.11
|
| Rate for Payer: Healthscope Commercial |
$47.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.33
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.77
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.57
|
| Rate for Payer: Nomi Health Commercial |
$43.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.11
|
| Rate for Payer: PHP Commercial |
$44.57
|
| Rate for Payer: PHP Medicare Advantage |
$13.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.09
|
| Rate for Payer: Priority Health HMO/PPO |
$45.62
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.13
|
| Rate for Payer: Railroad Medicare Medicare |
$13.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.15
|
| Rate for Payer: UHC Core |
$43.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.11
|
| Rate for Payer: UHC Exchange |
$13.11
|
| Rate for Payer: UHC Medicare Advantage |
$13.11
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.33
|
|
