|
HC FETAL SCREEN ROSETTE
|
Facility
|
IP
|
$72.60
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
30500047
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.28 |
| Max. Negotiated Rate |
$65.34 |
| Rate for Payer: Aetna Commercial |
$61.71
|
| Rate for Payer: BCBS Trust/PPO |
$56.11
|
| Rate for Payer: BCN Commercial |
$56.11
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.08
|
| Rate for Payer: Healthscope Commercial |
$65.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.71
|
| Rate for Payer: PHP Commercial |
$61.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.89
|
| Rate for Payer: UHC Core |
$60.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.45
|
|
|
HC FETAL SCREEN ROSETTE
|
Facility
|
OP
|
$72.60
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
30500047
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$65.34 |
| Rate for Payer: Aetna Commercial |
$61.71
|
| Rate for Payer: Aetna Medicare |
$18.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.69
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS MAPPO |
$18.15
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$56.45
|
| Rate for Payer: BCN Medicare Advantage |
$18.15
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Cofinity Commercial |
$62.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.15
|
| Rate for Payer: Healthscope Commercial |
$65.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.45
|
| Rate for Payer: Mclaren Medicaid |
$6.91
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.71
|
| Rate for Payer: PACE Senior Care Partners |
$17.24
|
| Rate for Payer: PACE SWMI |
$18.15
|
| Rate for Payer: PHP Commercial |
$61.71
|
| Rate for Payer: PHP Medicare Advantage |
$18.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.16
|
| Rate for Payer: Priority Health Medicare |
$18.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.28
|
| Rate for Payer: Railroad Medicare Medicare |
$18.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.89
|
| Rate for Payer: UHC Core |
$60.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.69
|
| Rate for Payer: VA VA |
$18.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.45
|
|
|
HC FETUS EACH ADDL GESTATION
|
Facility
|
IP
|
$202.59
|
|
|
Service Code
|
CPT 74713
|
| Hospital Charge Code |
61000084
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$123.56 |
| Max. Negotiated Rate |
$182.33 |
| Rate for Payer: Aetna Commercial |
$172.20
|
| Rate for Payer: BCBS Trust/PPO |
$156.56
|
| Rate for Payer: BCN Commercial |
$156.56
|
| Rate for Payer: Cash Price |
$162.07
|
| Rate for Payer: Cofinity Commercial |
$174.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.07
|
| Rate for Payer: Healthscope Commercial |
$182.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.20
|
| Rate for Payer: PHP Commercial |
$172.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.28
|
| Rate for Payer: UHC Core |
$169.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.94
|
|
|
HC FETUS EACH ADDL GESTATION
|
Facility
|
OP
|
$202.59
|
|
|
Service Code
|
CPT 74713
|
| Hospital Charge Code |
61000084
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$48.12 |
| Max. Negotiated Rate |
$182.33 |
| Rate for Payer: Aetna Commercial |
$172.20
|
| Rate for Payer: Aetna Medicare |
$52.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.31
|
| Rate for Payer: BCBS Complete |
$81.04
|
| Rate for Payer: BCBS MAPPO |
$50.65
|
| Rate for Payer: BCBS Trust/PPO |
$157.51
|
| Rate for Payer: BCN Commercial |
$157.51
|
| Rate for Payer: BCN Medicare Advantage |
$50.65
|
| Rate for Payer: Cash Price |
$162.07
|
| Rate for Payer: Cofinity Commercial |
$174.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.65
|
| Rate for Payer: Healthscope Commercial |
$182.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.20
|
| Rate for Payer: PACE Senior Care Partners |
$48.12
|
| Rate for Payer: PACE SWMI |
$50.65
|
| Rate for Payer: PHP Commercial |
$172.20
|
| Rate for Payer: PHP Medicare Advantage |
$50.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.25
|
| Rate for Payer: Priority Health Medicare |
$50.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.56
|
| Rate for Payer: Railroad Medicare Medicare |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.28
|
| Rate for Payer: UHC Core |
$169.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.65
|
| Rate for Payer: UHC Medicare Advantage |
$52.17
|
| Rate for Payer: VA VA |
$50.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.94
|
|
|
HC FETUS SINGLE OR FIRST GESTATION
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 74712
|
| Hospital Charge Code |
61000083
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$72.68 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.62
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$237.92
|
| Rate for Payer: BCN Commercial |
$237.92
|
| Rate for Payer: BCN Medicare Advantage |
$76.50
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.50
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PACE Senior Care Partners |
$72.68
|
| Rate for Payer: PACE SWMI |
$76.50
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$76.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.22
|
| Rate for Payer: Priority Health Medicare |
$76.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.63
|
| Rate for Payer: Railroad Medicare Medicare |
$76.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.50
|
| Rate for Payer: UHC Medicare Advantage |
$78.80
|
| Rate for Payer: VA VA |
$76.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC FETUS SINGLE OR FIRST GESTATION
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 74712
|
| Hospital Charge Code |
61000083
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$186.63 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: BCBS Trust/PPO |
$236.48
|
| Rate for Payer: BCN Commercial |
$236.48
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC FFR DEVICE
|
Facility
|
IP
|
$2,055.39
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,253.58 |
| Max. Negotiated Rate |
$1,849.85 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,588.41
|
| Rate for Payer: BCN Commercial |
$1,588.41
|
| Rate for Payer: Cash Price |
$1,644.31
|
| Rate for Payer: Cofinity Commercial |
$1,767.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.31
|
| Rate for Payer: Healthscope Commercial |
$1,849.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,747.08
|
| Rate for Payer: PHP Commercial |
$1,747.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,788.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,253.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,808.74
|
| Rate for Payer: UHC Core |
$1,716.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.54
|
|
|
HC FFR DEVICE
|
Facility
|
OP
|
$2,055.39
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$488.16 |
| Max. Negotiated Rate |
$1,849.85 |
| Rate for Payer: Aetna Commercial |
$1,747.08
|
| Rate for Payer: Aetna Medicare |
$534.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$642.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$642.31
|
| Rate for Payer: BCBS Complete |
$822.16
|
| Rate for Payer: BCBS MAPPO |
$513.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.07
|
| Rate for Payer: BCN Commercial |
$1,598.07
|
| Rate for Payer: BCN Medicare Advantage |
$513.85
|
| Rate for Payer: Cash Price |
$1,644.31
|
| Rate for Payer: Cofinity Commercial |
$1,767.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.85
|
| Rate for Payer: Healthscope Commercial |
$1,849.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$539.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,747.08
|
| Rate for Payer: PACE Senior Care Partners |
$488.16
|
| Rate for Payer: PACE SWMI |
$513.85
|
| Rate for Payer: PHP Commercial |
$1,747.08
|
| Rate for Payer: PHP Medicare Advantage |
$513.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,788.19
|
| Rate for Payer: Priority Health Medicare |
$513.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,253.58
|
| Rate for Payer: Railroad Medicare Medicare |
$513.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,808.74
|
| Rate for Payer: UHC Core |
$1,716.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.85
|
| Rate for Payer: UHC Medicare Advantage |
$529.26
|
| Rate for Payer: VA VA |
$513.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.54
|
|
|
HC FFR MEASUREMENT
|
Facility
|
OP
|
$3,802.52
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
48100027
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$903.10 |
| Max. Negotiated Rate |
$3,422.27 |
| Rate for Payer: Aetna Commercial |
$3,232.14
|
| Rate for Payer: Aetna Medicare |
$988.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,188.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,188.29
|
| Rate for Payer: BCBS Complete |
$1,521.01
|
| Rate for Payer: BCBS MAPPO |
$950.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,956.46
|
| Rate for Payer: BCN Commercial |
$2,956.46
|
| Rate for Payer: BCN Medicare Advantage |
$950.63
|
| Rate for Payer: Cash Price |
$3,042.02
|
| Rate for Payer: Cofinity Commercial |
$3,270.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,042.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.63
|
| Rate for Payer: Healthscope Commercial |
$3,422.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$998.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,093.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,232.14
|
| Rate for Payer: PACE Senior Care Partners |
$903.10
|
| Rate for Payer: PACE SWMI |
$950.63
|
| Rate for Payer: PHP Commercial |
$3,232.14
|
| Rate for Payer: PHP Medicare Advantage |
$950.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,308.19
|
| Rate for Payer: Priority Health Medicare |
$950.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,319.16
|
| Rate for Payer: Railroad Medicare Medicare |
$950.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,346.22
|
| Rate for Payer: UHC Core |
$3,175.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.63
|
| Rate for Payer: UHC Medicare Advantage |
$979.15
|
| Rate for Payer: VA VA |
$950.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.89
|
|
|
HC FFR MEASUREMENT
|
Facility
|
IP
|
$3,802.52
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
48100027
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,319.16 |
| Max. Negotiated Rate |
$3,422.27 |
| Rate for Payer: Aetna Commercial |
$3,232.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,938.59
|
| Rate for Payer: BCN Commercial |
$2,938.59
|
| Rate for Payer: Cash Price |
$3,042.02
|
| Rate for Payer: Cofinity Commercial |
$3,270.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,042.02
|
| Rate for Payer: Healthscope Commercial |
$3,422.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,232.14
|
| Rate for Payer: PHP Commercial |
$3,232.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,661.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,308.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,319.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,346.22
|
| Rate for Payer: UHC Core |
$3,175.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.89
|
|
|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
OP
|
$824.08
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$195.72 |
| Max. Negotiated Rate |
$741.67 |
| Rate for Payer: Aetna Commercial |
$700.47
|
| Rate for Payer: Aetna Medicare |
$214.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$257.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$257.52
|
| Rate for Payer: BCBS Complete |
$329.63
|
| Rate for Payer: BCBS MAPPO |
$206.02
|
| Rate for Payer: BCBS Trust/PPO |
$640.72
|
| Rate for Payer: BCN Commercial |
$640.72
|
| Rate for Payer: BCN Medicare Advantage |
$206.02
|
| Rate for Payer: Cash Price |
$659.26
|
| Rate for Payer: Cofinity Commercial |
$708.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$659.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.02
|
| Rate for Payer: Healthscope Commercial |
$741.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$700.47
|
| Rate for Payer: PACE Senior Care Partners |
$195.72
|
| Rate for Payer: PACE SWMI |
$206.02
|
| Rate for Payer: PHP Commercial |
$700.47
|
| Rate for Payer: PHP Medicare Advantage |
$206.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.95
|
| Rate for Payer: Priority Health Medicare |
$206.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.61
|
| Rate for Payer: Railroad Medicare Medicare |
$206.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.19
|
| Rate for Payer: UHC Core |
$688.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.02
|
| Rate for Payer: UHC Medicare Advantage |
$212.20
|
| Rate for Payer: VA VA |
$206.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.06
|
|
|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
IP
|
$824.08
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$502.61 |
| Max. Negotiated Rate |
$741.67 |
| Rate for Payer: Aetna Commercial |
$700.47
|
| Rate for Payer: BCBS Trust/PPO |
$636.85
|
| Rate for Payer: BCN Commercial |
$636.85
|
| Rate for Payer: Cash Price |
$659.26
|
| Rate for Payer: Cofinity Commercial |
$708.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$659.26
|
| Rate for Payer: Healthscope Commercial |
$741.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$700.47
|
| Rate for Payer: PHP Commercial |
$700.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.19
|
| Rate for Payer: UHC Core |
$688.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.06
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
OP
|
$2,623.95
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$623.19 |
| Max. Negotiated Rate |
$2,361.56 |
| Rate for Payer: Aetna Commercial |
$2,230.36
|
| Rate for Payer: Aetna Medicare |
$682.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$819.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$819.98
|
| Rate for Payer: BCBS Complete |
$1,049.58
|
| Rate for Payer: BCBS MAPPO |
$655.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,040.12
|
| Rate for Payer: BCN Commercial |
$2,040.12
|
| Rate for Payer: BCN Medicare Advantage |
$655.99
|
| Rate for Payer: Cash Price |
$2,099.16
|
| Rate for Payer: Cofinity Commercial |
$2,256.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,099.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.99
|
| Rate for Payer: Healthscope Commercial |
$2,361.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,967.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$688.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$754.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,230.36
|
| Rate for Payer: PACE Senior Care Partners |
$623.19
|
| Rate for Payer: PACE SWMI |
$655.99
|
| Rate for Payer: PHP Commercial |
$2,230.36
|
| Rate for Payer: PHP Medicare Advantage |
$655.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,836.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,282.84
|
| Rate for Payer: Priority Health Medicare |
$655.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,600.35
|
| Rate for Payer: Railroad Medicare Medicare |
$655.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,309.08
|
| Rate for Payer: UHC Core |
$2,191.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.99
|
| Rate for Payer: UHC Medicare Advantage |
$675.67
|
| Rate for Payer: VA VA |
$655.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,967.96
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
IP
|
$2,623.95
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,600.35 |
| Max. Negotiated Rate |
$2,361.56 |
| Rate for Payer: Aetna Commercial |
$2,230.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,027.79
|
| Rate for Payer: BCN Commercial |
$2,027.79
|
| Rate for Payer: Cash Price |
$2,099.16
|
| Rate for Payer: Cofinity Commercial |
$2,256.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,099.16
|
| Rate for Payer: Healthscope Commercial |
$2,361.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,967.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,230.36
|
| Rate for Payer: PHP Commercial |
$2,230.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,836.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,282.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,600.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,309.08
|
| Rate for Payer: UHC Core |
$2,191.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,967.96
|
|
|
HC FIBRINOGEN
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$7.53
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Meridian Medicaid |
$7.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC FIBRINOGEN
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$173.82 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$220.25
|
| Rate for Payer: BCN Commercial |
$220.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.28 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: Aetna Medicare |
$74.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.06
|
| Rate for Payer: BCBS Complete |
$55.94
|
| Rate for Payer: BCBS MAPPO |
$71.25
|
| Rate for Payer: BCBS Trust/PPO |
$221.59
|
| Rate for Payer: BCN Commercial |
$221.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.25
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Mclaren Medicaid |
$53.28
|
| Rate for Payer: Meridian Medicaid |
$55.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$74.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: PACE Senior Care Partners |
$67.69
|
| Rate for Payer: PACE SWMI |
$71.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: PHP Medicare Advantage |
$71.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.95
|
| Rate for Payer: Priority Health Medicare |
$71.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.82
|
| Rate for Payer: Railroad Medicare Medicare |
$71.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.25
|
| Rate for Payer: UHC Medicare Advantage |
$73.39
|
| Rate for Payer: VA VA |
$71.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC FILSHIE CLIP
|
Facility
|
IP
|
$329.24
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$200.80 |
| Max. Negotiated Rate |
$296.32 |
| Rate for Payer: Aetna Commercial |
$279.85
|
| Rate for Payer: BCBS Trust/PPO |
$254.44
|
| Rate for Payer: BCN Commercial |
$254.44
|
| Rate for Payer: Cash Price |
$263.39
|
| Rate for Payer: Cofinity Commercial |
$283.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.39
|
| Rate for Payer: Healthscope Commercial |
$296.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$279.85
|
| Rate for Payer: PHP Commercial |
$279.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.73
|
| Rate for Payer: UHC Core |
$274.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.93
|
|
|
HC FILSHIE CLIP
|
Facility
|
OP
|
$329.24
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.19 |
| Max. Negotiated Rate |
$296.32 |
| Rate for Payer: Aetna Commercial |
$279.85
|
| Rate for Payer: Aetna Medicare |
$85.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.89
|
| Rate for Payer: BCBS Complete |
$131.70
|
| Rate for Payer: BCBS MAPPO |
$82.31
|
| Rate for Payer: BCBS Trust/PPO |
$255.98
|
| Rate for Payer: BCN Commercial |
$255.98
|
| Rate for Payer: BCN Medicare Advantage |
$82.31
|
| Rate for Payer: Cash Price |
$263.39
|
| Rate for Payer: Cofinity Commercial |
$283.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.31
|
| Rate for Payer: Healthscope Commercial |
$296.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$279.85
|
| Rate for Payer: PACE Senior Care Partners |
$78.19
|
| Rate for Payer: PACE SWMI |
$82.31
|
| Rate for Payer: PHP Commercial |
$279.85
|
| Rate for Payer: PHP Medicare Advantage |
$82.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.44
|
| Rate for Payer: Priority Health Medicare |
$82.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.80
|
| Rate for Payer: Railroad Medicare Medicare |
$82.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.73
|
| Rate for Payer: UHC Core |
$274.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.31
|
| Rate for Payer: UHC Medicare Advantage |
$84.78
|
| Rate for Payer: VA VA |
$82.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.93
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
OP
|
$57.00
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$14.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.81
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$14.25
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.25
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Senior Care Partners |
$13.54
|
| Rate for Payer: PACE SWMI |
$14.25
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$14.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$14.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.25
|
| Rate for Payer: UHC Medicare Advantage |
$14.68
|
| Rate for Payer: VA VA |
$14.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
IP
|
$57.00
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$44.05
|
| Rate for Payer: BCN Commercial |
$44.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC FILTERWIRE
|
Facility
|
OP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$888.17 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: Aetna Medicare |
$972.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,168.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,168.64
|
| Rate for Payer: BCBS Complete |
$1,495.86
|
| Rate for Payer: BCBS MAPPO |
$934.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,907.59
|
| Rate for Payer: BCN Commercial |
$2,907.59
|
| Rate for Payer: BCN Medicare Advantage |
$934.92
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.92
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,804.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$981.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,075.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PACE Senior Care Partners |
$888.17
|
| Rate for Payer: PACE SWMI |
$934.92
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: PHP Medicare Advantage |
$934.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,253.50
|
| Rate for Payer: Priority Health Medicare |
$934.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,280.82
|
| Rate for Payer: Railroad Medicare Medicare |
$934.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,290.90
|
| Rate for Payer: UHC Core |
$3,122.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.92
|
| Rate for Payer: UHC Medicare Advantage |
$962.96
|
| Rate for Payer: VA VA |
$934.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,804.74
|
|
|
HC FILTERWIRE
|
Facility
|
IP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,280.82 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.01
|
| Rate for Payer: BCN Commercial |
$2,890.01
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,804.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,253.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,280.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,290.90
|
| Rate for Payer: UHC Core |
$3,122.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,804.74
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
IP
|
$20.40
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
