|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
OP
|
$3,147.33
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$554.87 |
| Max. Negotiated Rate |
$2,832.60 |
| Rate for Payer: Aetna Commercial |
$2,675.23
|
| Rate for Payer: Aetna Medicare |
$818.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$983.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$983.54
|
| Rate for Payer: BCBS Complete |
$582.57
|
| Rate for Payer: BCBS MAPPO |
$786.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,587.42
|
| Rate for Payer: BCN Commercial |
$2,587.42
|
| Rate for Payer: BCN Medicare Advantage |
$786.83
|
| Rate for Payer: Cash Price |
$2,517.86
|
| Rate for Payer: Cofinity Commercial |
$2,706.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,517.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.83
|
| Rate for Payer: Healthscope Commercial |
$2,832.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,360.50
|
| Rate for Payer: Mclaren Medicaid |
$554.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.17
|
| Rate for Payer: Meridian Medicaid |
$582.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$904.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$865.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,675.23
|
| Rate for Payer: Nomi Health Commercial |
$2,580.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,360.50
|
| Rate for Payer: PACE Senior Care Partners |
$747.49
|
| Rate for Payer: PACE SWMI |
$786.83
|
| Rate for Payer: PHP Commercial |
$2,675.23
|
| Rate for Payer: PHP Medicare Advantage |
$786.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$554.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,738.18
|
| Rate for Payer: Priority Health Medicare |
$794.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,190.54
|
| Rate for Payer: Railroad Medicare Medicare |
$786.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,769.65
|
| Rate for Payer: UHC Core |
$2,628.02
|
| Rate for Payer: UHC Exchange |
$786.83
|
| Rate for Payer: UHC Medicaid |
$554.87
|
| Rate for Payer: UHC Medicare Advantage |
$786.83
|
| Rate for Payer: UHCCP Medicaid |
$554.87
|
| Rate for Payer: VA VA |
$786.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,360.50
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
IP
|
$3,147.33
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$2,190.54 |
| Max. Negotiated Rate |
$2,832.60 |
| Rate for Payer: Aetna Commercial |
$2,675.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,599.38
|
| Rate for Payer: BCN Commercial |
$2,599.38
|
| Rate for Payer: Cash Price |
$2,517.86
|
| Rate for Payer: Cofinity Commercial |
$2,706.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,517.86
|
| Rate for Payer: Healthscope Commercial |
$2,832.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,360.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,675.23
|
| Rate for Payer: Nomi Health Commercial |
$2,580.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,360.50
|
| Rate for Payer: PHP Commercial |
$2,675.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,738.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,190.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,769.65
|
| Rate for Payer: UHC Core |
$2,628.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,360.50
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
IP
|
$1,343.28
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$934.92 |
| Max. Negotiated Rate |
$1,208.95 |
| Rate for Payer: Aetna Commercial |
$1,141.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.41
|
| Rate for Payer: BCN Commercial |
$1,109.41
|
| Rate for Payer: Cash Price |
$1,074.62
|
| Rate for Payer: Cofinity Commercial |
$1,155.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.62
|
| Rate for Payer: Healthscope Commercial |
$1,208.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.79
|
| Rate for Payer: Nomi Health Commercial |
$1,101.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.46
|
| Rate for Payer: PHP Commercial |
$1,141.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,168.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$934.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,182.09
|
| Rate for Payer: UHC Core |
$1,121.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.46
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
OP
|
$1,343.28
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$236.82 |
| Max. Negotiated Rate |
$1,208.95 |
| Rate for Payer: Aetna Commercial |
$1,141.79
|
| Rate for Payer: Aetna Medicare |
$349.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$419.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$419.77
|
| Rate for Payer: BCBS Complete |
$248.64
|
| Rate for Payer: BCBS MAPPO |
$335.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.31
|
| Rate for Payer: BCN Commercial |
$1,104.31
|
| Rate for Payer: BCN Medicare Advantage |
$335.82
|
| Rate for Payer: Cash Price |
$1,074.62
|
| Rate for Payer: Cofinity Commercial |
$1,155.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.82
|
| Rate for Payer: Healthscope Commercial |
$1,208.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.46
|
| Rate for Payer: Mclaren Medicaid |
$236.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.61
|
| Rate for Payer: Meridian Medicaid |
$248.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$386.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$369.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.79
|
| Rate for Payer: Nomi Health Commercial |
$1,101.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,007.46
|
| Rate for Payer: PACE Senior Care Partners |
$319.03
|
| Rate for Payer: PACE SWMI |
$335.82
|
| Rate for Payer: PHP Commercial |
$1,141.79
|
| Rate for Payer: PHP Medicare Advantage |
$335.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,168.65
|
| Rate for Payer: Priority Health Medicare |
$339.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$934.92
|
| Rate for Payer: Railroad Medicare Medicare |
$335.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,182.09
|
| Rate for Payer: UHC Core |
$1,121.64
|
| Rate for Payer: UHC Exchange |
$335.82
|
| Rate for Payer: UHC Medicaid |
$236.82
|
| Rate for Payer: UHC Medicare Advantage |
$335.82
|
| Rate for Payer: UHCCP Medicaid |
$236.82
|
| Rate for Payer: VA VA |
$335.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.46
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
OP
|
$2,199.56
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$387.78 |
| Max. Negotiated Rate |
$1,979.60 |
| Rate for Payer: Aetna Commercial |
$1,869.63
|
| Rate for Payer: Aetna Medicare |
$571.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$687.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$687.36
|
| Rate for Payer: BCBS Complete |
$407.14
|
| Rate for Payer: BCBS MAPPO |
$549.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,808.26
|
| Rate for Payer: BCN Commercial |
$1,808.26
|
| Rate for Payer: BCN Medicare Advantage |
$549.89
|
| Rate for Payer: Cash Price |
$1,759.65
|
| Rate for Payer: Cofinity Commercial |
$1,891.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.89
|
| Rate for Payer: Healthscope Commercial |
$1,979.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.67
|
| Rate for Payer: Mclaren Medicaid |
$387.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.38
|
| Rate for Payer: Meridian Medicaid |
$407.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$632.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$604.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.63
|
| Rate for Payer: Nomi Health Commercial |
$1,803.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,649.67
|
| Rate for Payer: PACE Senior Care Partners |
$522.40
|
| Rate for Payer: PACE SWMI |
$549.89
|
| Rate for Payer: PHP Commercial |
$1,869.63
|
| Rate for Payer: PHP Medicare Advantage |
$549.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$387.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,913.62
|
| Rate for Payer: Priority Health Medicare |
$555.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,530.89
|
| Rate for Payer: Railroad Medicare Medicare |
$549.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.61
|
| Rate for Payer: UHC Core |
$1,836.63
|
| Rate for Payer: UHC Exchange |
$549.89
|
| Rate for Payer: UHC Medicaid |
$387.78
|
| Rate for Payer: UHC Medicare Advantage |
$549.89
|
| Rate for Payer: UHCCP Medicaid |
$387.78
|
| Rate for Payer: VA VA |
$549.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.67
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
IP
|
$2,199.56
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,530.89 |
| Max. Negotiated Rate |
$1,979.60 |
| Rate for Payer: Aetna Commercial |
$1,869.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,816.62
|
| Rate for Payer: BCN Commercial |
$1,816.62
|
| Rate for Payer: Cash Price |
$1,759.65
|
| Rate for Payer: Cofinity Commercial |
$1,891.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,759.65
|
| Rate for Payer: Healthscope Commercial |
$1,979.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,649.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,869.63
|
| Rate for Payer: Nomi Health Commercial |
$1,803.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,649.67
|
| Rate for Payer: PHP Commercial |
$1,869.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,913.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,530.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,935.61
|
| Rate for Payer: UHC Core |
$1,836.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,649.67
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
IP
|
$705.54
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$491.06 |
| Max. Negotiated Rate |
$634.99 |
| Rate for Payer: Aetna Commercial |
$599.71
|
| Rate for Payer: BCBS Trust/PPO |
$582.71
|
| Rate for Payer: BCN Commercial |
$582.71
|
| Rate for Payer: Cash Price |
$564.43
|
| Rate for Payer: Cofinity Commercial |
$606.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.43
|
| Rate for Payer: Healthscope Commercial |
$634.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.71
|
| Rate for Payer: Nomi Health Commercial |
$578.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.15
|
| Rate for Payer: PHP Commercial |
$599.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.88
|
| Rate for Payer: UHC Core |
$589.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.15
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
OP
|
$705.54
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.39 |
| Max. Negotiated Rate |
$634.99 |
| Rate for Payer: Aetna Commercial |
$599.71
|
| Rate for Payer: Aetna Medicare |
$183.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.48
|
| Rate for Payer: BCBS Complete |
$130.60
|
| Rate for Payer: BCBS MAPPO |
$176.38
|
| Rate for Payer: BCBS Trust/PPO |
$580.02
|
| Rate for Payer: BCN Commercial |
$580.02
|
| Rate for Payer: BCN Medicare Advantage |
$176.38
|
| Rate for Payer: Cash Price |
$564.43
|
| Rate for Payer: Cofinity Commercial |
$606.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.38
|
| Rate for Payer: Healthscope Commercial |
$634.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.15
|
| Rate for Payer: Mclaren Medicaid |
$124.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.20
|
| Rate for Payer: Meridian Medicaid |
$130.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.71
|
| Rate for Payer: Nomi Health Commercial |
$578.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.15
|
| Rate for Payer: PACE Senior Care Partners |
$167.57
|
| Rate for Payer: PACE SWMI |
$176.38
|
| Rate for Payer: PHP Commercial |
$599.71
|
| Rate for Payer: PHP Medicare Advantage |
$176.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.82
|
| Rate for Payer: Priority Health Medicare |
$178.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.06
|
| Rate for Payer: Railroad Medicare Medicare |
$176.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.88
|
| Rate for Payer: UHC Core |
$589.13
|
| Rate for Payer: UHC Exchange |
$176.38
|
| Rate for Payer: UHC Medicaid |
$124.39
|
| Rate for Payer: UHC Medicare Advantage |
$176.38
|
| Rate for Payer: UHCCP Medicaid |
$124.39
|
| Rate for Payer: VA VA |
$176.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.15
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WITH CONCURR CT/CTA
|
Facility
|
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 70472
|
| Hospital Charge Code |
35100013
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$189.17 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Aetna Commercial |
$912.05
|
| Rate for Payer: Aetna Medicare |
$278.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.31
|
| Rate for Payer: BCBS Complete |
$198.61
|
| Rate for Payer: BCBS MAPPO |
$268.25
|
| Rate for Payer: BCBS Trust/PPO |
$882.11
|
| Rate for Payer: BCN Commercial |
$882.11
|
| Rate for Payer: BCN Medicare Advantage |
$268.25
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Commercial |
$922.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.25
|
| Rate for Payer: Healthscope Commercial |
$965.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.75
|
| Rate for Payer: Mclaren Medicaid |
$189.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.66
|
| Rate for Payer: Meridian Medicaid |
$198.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.05
|
| Rate for Payer: Nomi Health Commercial |
$879.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PACE Senior Care Partners |
$254.84
|
| Rate for Payer: PACE SWMI |
$268.25
|
| Rate for Payer: PHP Commercial |
$912.05
|
| Rate for Payer: PHP Medicare Advantage |
$268.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.51
|
| Rate for Payer: Priority Health Medicare |
$270.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.81
|
| Rate for Payer: Railroad Medicare Medicare |
$268.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.24
|
| Rate for Payer: UHC Core |
$895.96
|
| Rate for Payer: UHC Exchange |
$268.25
|
| Rate for Payer: UHC Medicaid |
$189.17
|
| Rate for Payer: UHC Medicare Advantage |
$268.25
|
| Rate for Payer: UHCCP Medicaid |
$189.17
|
| Rate for Payer: VA VA |
$268.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.75
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WITH CONCURR CT/CTA
|
Facility
|
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 70472
|
| Hospital Charge Code |
35100013
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$746.81 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Aetna Commercial |
$912.05
|
| Rate for Payer: BCBS Trust/PPO |
$886.19
|
| Rate for Payer: BCN Commercial |
$886.19
|
| Rate for Payer: Cash Price |
$858.40
|
| Rate for Payer: Cofinity Commercial |
$922.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.40
|
| Rate for Payer: Healthscope Commercial |
$965.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.05
|
| Rate for Payer: Nomi Health Commercial |
$879.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.75
|
| Rate for Payer: PHP Commercial |
$912.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.24
|
| Rate for Payer: UHC Core |
$895.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.75
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WO CONCURR CT/CTA
|
Facility
|
IP
|
$1,033.50
|
|
|
Service Code
|
HCPCS 70473
|
| Hospital Charge Code |
35100014
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$719.32 |
| Max. Negotiated Rate |
$930.15 |
| Rate for Payer: Aetna Commercial |
$878.48
|
| Rate for Payer: BCBS Trust/PPO |
$853.57
|
| Rate for Payer: BCN Commercial |
$853.57
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cofinity Commercial |
$888.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.80
|
| Rate for Payer: Healthscope Commercial |
$930.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.48
|
| Rate for Payer: Nomi Health Commercial |
$847.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.12
|
| Rate for Payer: PHP Commercial |
$878.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.48
|
| Rate for Payer: UHC Core |
$862.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.12
|
|
|
HC CT BRAIN PERF ANAL W CONTRAST WO CONCURR CT/CTA
|
Facility
|
OP
|
$1,033.50
|
|
|
Service Code
|
HCPCS 70473
|
| Hospital Charge Code |
35100014
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$182.21 |
| Max. Negotiated Rate |
$930.15 |
| Rate for Payer: Aetna Commercial |
$878.48
|
| Rate for Payer: Aetna Medicare |
$268.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.97
|
| Rate for Payer: BCBS Complete |
$191.30
|
| Rate for Payer: BCBS MAPPO |
$258.38
|
| Rate for Payer: BCBS Trust/PPO |
$849.64
|
| Rate for Payer: BCN Commercial |
$849.64
|
| Rate for Payer: BCN Medicare Advantage |
$258.38
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cofinity Commercial |
$888.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.38
|
| Rate for Payer: Healthscope Commercial |
$930.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.12
|
| Rate for Payer: Mclaren Medicaid |
$182.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.29
|
| Rate for Payer: Meridian Medicaid |
$191.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.48
|
| Rate for Payer: Nomi Health Commercial |
$847.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.12
|
| Rate for Payer: PACE Senior Care Partners |
$245.46
|
| Rate for Payer: PACE SWMI |
$258.38
|
| Rate for Payer: PHP Commercial |
$878.48
|
| Rate for Payer: PHP Medicare Advantage |
$258.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.14
|
| Rate for Payer: Priority Health Medicare |
$260.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.32
|
| Rate for Payer: Railroad Medicare Medicare |
$258.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.48
|
| Rate for Payer: UHC Core |
$862.97
|
| Rate for Payer: UHC Exchange |
$258.38
|
| Rate for Payer: UHC Medicaid |
$182.21
|
| Rate for Payer: UHC Medicare Advantage |
$258.38
|
| Rate for Payer: UHCCP Medicaid |
$182.21
|
| Rate for Payer: VA VA |
$258.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.12
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
IP
|
$1,073.09
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$746.87 |
| Max. Negotiated Rate |
$965.78 |
| Rate for Payer: Aetna Commercial |
$912.13
|
| Rate for Payer: BCBS Trust/PPO |
$886.27
|
| Rate for Payer: BCN Commercial |
$886.27
|
| Rate for Payer: Cash Price |
$858.47
|
| Rate for Payer: Cofinity Commercial |
$922.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.47
|
| Rate for Payer: Healthscope Commercial |
$965.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.13
|
| Rate for Payer: Nomi Health Commercial |
$879.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.82
|
| Rate for Payer: PHP Commercial |
$912.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.32
|
| Rate for Payer: UHC Core |
$896.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.82
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
OP
|
$1,073.09
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$189.19 |
| Max. Negotiated Rate |
$965.78 |
| Rate for Payer: Aetna Commercial |
$912.13
|
| Rate for Payer: Aetna Medicare |
$279.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.34
|
| Rate for Payer: BCBS Complete |
$198.63
|
| Rate for Payer: BCBS MAPPO |
$268.27
|
| Rate for Payer: BCBS Trust/PPO |
$882.19
|
| Rate for Payer: BCN Commercial |
$882.19
|
| Rate for Payer: BCN Medicare Advantage |
$268.27
|
| Rate for Payer: Cash Price |
$858.47
|
| Rate for Payer: Cofinity Commercial |
$922.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.27
|
| Rate for Payer: Healthscope Commercial |
$965.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.82
|
| Rate for Payer: Mclaren Medicaid |
$189.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.69
|
| Rate for Payer: Meridian Medicaid |
$198.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.13
|
| Rate for Payer: Nomi Health Commercial |
$879.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.82
|
| Rate for Payer: PACE Senior Care Partners |
$254.86
|
| Rate for Payer: PACE SWMI |
$268.27
|
| Rate for Payer: PHP Commercial |
$912.13
|
| Rate for Payer: PHP Medicare Advantage |
$268.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.59
|
| Rate for Payer: Priority Health Medicare |
$270.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.87
|
| Rate for Payer: Railroad Medicare Medicare |
$268.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.32
|
| Rate for Payer: UHC Core |
$896.03
|
| Rate for Payer: UHC Exchange |
$268.27
|
| Rate for Payer: UHC Medicaid |
$189.19
|
| Rate for Payer: UHC Medicare Advantage |
$268.27
|
| Rate for Payer: UHCCP Medicaid |
$189.19
|
| Rate for Payer: VA VA |
$268.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.82
|
|
|
HC CT BRAIN W CON
|
Facility
|
IP
|
$1,655.16
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,151.99 |
| Max. Negotiated Rate |
$1,489.64 |
| Rate for Payer: Aetna Commercial |
$1,406.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.00
|
| Rate for Payer: BCN Commercial |
$1,367.00
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cofinity Commercial |
$1,423.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,324.13
|
| Rate for Payer: Healthscope Commercial |
$1,489.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,241.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,406.89
|
| Rate for Payer: Nomi Health Commercial |
$1,357.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,241.37
|
| Rate for Payer: PHP Commercial |
$1,406.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,439.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.54
|
| Rate for Payer: UHC Core |
$1,382.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,241.37
|
|
|
HC CT BRAIN W CON
|
Facility
|
OP
|
$1,655.16
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$291.80 |
| Max. Negotiated Rate |
$1,489.64 |
| Rate for Payer: Aetna Commercial |
$1,406.89
|
| Rate for Payer: Aetna Medicare |
$430.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$517.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$517.24
|
| Rate for Payer: BCBS Complete |
$306.37
|
| Rate for Payer: BCBS MAPPO |
$413.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.71
|
| Rate for Payer: BCN Commercial |
$1,360.71
|
| Rate for Payer: BCN Medicare Advantage |
$413.79
|
| Rate for Payer: Cash Price |
$1,324.13
|
| Rate for Payer: Cofinity Commercial |
$1,423.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,324.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.79
|
| Rate for Payer: Healthscope Commercial |
$1,489.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,241.37
|
| Rate for Payer: Mclaren Medicaid |
$291.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$434.48
|
| Rate for Payer: Meridian Medicaid |
$306.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$475.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,406.89
|
| Rate for Payer: Nomi Health Commercial |
$1,357.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,241.37
|
| Rate for Payer: PACE Senior Care Partners |
$393.10
|
| Rate for Payer: PACE SWMI |
$413.79
|
| Rate for Payer: PHP Commercial |
$1,406.89
|
| Rate for Payer: PHP Medicare Advantage |
$413.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,439.99
|
| Rate for Payer: Priority Health Medicare |
$417.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,151.99
|
| Rate for Payer: Railroad Medicare Medicare |
$413.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.54
|
| Rate for Payer: UHC Core |
$1,382.06
|
| Rate for Payer: UHC Exchange |
$413.79
|
| Rate for Payer: UHC Medicaid |
$291.80
|
| Rate for Payer: UHC Medicare Advantage |
$413.79
|
| Rate for Payer: UHCCP Medicaid |
$291.80
|
| Rate for Payer: VA VA |
$413.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,241.37
|
|
|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$272.28 |
| Max. Negotiated Rate |
$1,389.98 |
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: Aetna Medicare |
$401.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.63
|
| Rate for Payer: BCBS Complete |
$285.87
|
| Rate for Payer: BCBS MAPPO |
$386.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.67
|
| Rate for Payer: BCN Commercial |
$1,269.67
|
| Rate for Payer: BCN Medicare Advantage |
$386.11
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Commercial |
$1,328.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.11
|
| Rate for Payer: Healthscope Commercial |
$1,389.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.32
|
| Rate for Payer: Mclaren Medicaid |
$272.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.41
|
| Rate for Payer: Meridian Medicaid |
$285.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$444.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$424.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Nomi Health Commercial |
$1,266.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: PACE Senior Care Partners |
$366.80
|
| Rate for Payer: PACE SWMI |
$386.11
|
| Rate for Payer: PHP Commercial |
$1,312.76
|
| Rate for Payer: PHP Medicare Advantage |
$386.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,343.65
|
| Rate for Payer: Priority Health Medicare |
$389.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.92
|
| Rate for Payer: Railroad Medicare Medicare |
$386.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,359.09
|
| Rate for Payer: UHC Core |
$1,289.59
|
| Rate for Payer: UHC Exchange |
$386.11
|
| Rate for Payer: UHC Medicaid |
$272.28
|
| Rate for Payer: UHC Medicare Advantage |
$386.11
|
| Rate for Payer: UHCCP Medicaid |
$272.28
|
| Rate for Payer: VA VA |
$386.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.32
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,544.42
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,074.92 |
| Max. Negotiated Rate |
$1,389.98 |
| Rate for Payer: Aetna Commercial |
$1,312.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.54
|
| Rate for Payer: BCN Commercial |
$1,275.54
|
| Rate for Payer: Cash Price |
$1,235.54
|
| Rate for Payer: Cofinity Commercial |
$1,328.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.54
|
| Rate for Payer: Healthscope Commercial |
$1,389.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.76
|
| Rate for Payer: Nomi Health Commercial |
$1,266.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.32
|
| Rate for Payer: PHP Commercial |
$1,312.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,343.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,359.09
|
| Rate for Payer: UHC Core |
$1,289.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.32
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,862.42
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$328.34 |
| Max. Negotiated Rate |
$1,676.18 |
| Rate for Payer: Aetna Commercial |
$1,583.06
|
| Rate for Payer: Aetna Medicare |
$484.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.01
|
| Rate for Payer: BCBS Complete |
$344.73
|
| Rate for Payer: BCBS MAPPO |
$465.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.10
|
| Rate for Payer: BCN Commercial |
$1,531.10
|
| Rate for Payer: BCN Medicare Advantage |
$465.61
|
| Rate for Payer: Cash Price |
$1,489.94
|
| Rate for Payer: Cofinity Commercial |
$1,601.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,489.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.61
|
| Rate for Payer: Healthscope Commercial |
$1,676.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,396.82
|
| Rate for Payer: Mclaren Medicaid |
$328.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.89
|
| Rate for Payer: Meridian Medicaid |
$344.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$535.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$512.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,583.06
|
| Rate for Payer: Nomi Health Commercial |
$1,527.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,396.82
|
| Rate for Payer: PACE Senior Care Partners |
$442.32
|
| Rate for Payer: PACE SWMI |
$465.61
|
| Rate for Payer: PHP Commercial |
$1,583.06
|
| Rate for Payer: PHP Medicare Advantage |
$465.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$328.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,620.31
|
| Rate for Payer: Priority Health Medicare |
$470.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.24
|
| Rate for Payer: Railroad Medicare Medicare |
$465.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,638.93
|
| Rate for Payer: UHC Core |
$1,555.12
|
| Rate for Payer: UHC Exchange |
$465.61
|
| Rate for Payer: UHC Medicaid |
$328.34
|
| Rate for Payer: UHC Medicare Advantage |
$465.61
|
| Rate for Payer: UHCCP Medicaid |
$328.34
|
| Rate for Payer: VA VA |
$465.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,396.82
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,862.42
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,296.24 |
| Max. Negotiated Rate |
$1,676.18 |
| Rate for Payer: Aetna Commercial |
$1,583.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.17
|
| Rate for Payer: BCN Commercial |
$1,538.17
|
| Rate for Payer: Cash Price |
$1,489.94
|
| Rate for Payer: Cofinity Commercial |
$1,601.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,489.94
|
| Rate for Payer: Healthscope Commercial |
$1,676.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,396.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,583.06
|
| Rate for Payer: Nomi Health Commercial |
$1,527.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,396.82
|
| Rate for Payer: PHP Commercial |
$1,583.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,620.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,638.93
|
| Rate for Payer: UHC Core |
$1,555.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,396.82
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,109.36
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$371.88 |
| Max. Negotiated Rate |
$1,898.42 |
| Rate for Payer: Aetna Commercial |
$1,792.96
|
| Rate for Payer: Aetna Medicare |
$548.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.17
|
| Rate for Payer: BCBS Complete |
$390.44
|
| Rate for Payer: BCBS MAPPO |
$527.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,734.10
|
| Rate for Payer: BCN Commercial |
$1,734.10
|
| Rate for Payer: BCN Medicare Advantage |
$527.34
|
| Rate for Payer: Cash Price |
$1,687.49
|
| Rate for Payer: Cofinity Commercial |
$1,814.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,687.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.34
|
| Rate for Payer: Healthscope Commercial |
$1,898.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.02
|
| Rate for Payer: Mclaren Medicaid |
$371.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.71
|
| Rate for Payer: Meridian Medicaid |
$390.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$580.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,792.96
|
| Rate for Payer: Nomi Health Commercial |
$1,729.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.02
|
| Rate for Payer: PACE Senior Care Partners |
$500.97
|
| Rate for Payer: PACE SWMI |
$527.34
|
| Rate for Payer: PHP Commercial |
$1,792.96
|
| Rate for Payer: PHP Medicare Advantage |
$527.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,835.14
|
| Rate for Payer: Priority Health Medicare |
$532.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,468.11
|
| Rate for Payer: Railroad Medicare Medicare |
$527.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,856.24
|
| Rate for Payer: UHC Core |
$1,761.32
|
| Rate for Payer: UHC Exchange |
$527.34
|
| Rate for Payer: UHC Medicaid |
$371.88
|
| Rate for Payer: UHC Medicare Advantage |
$527.34
|
| Rate for Payer: UHCCP Medicaid |
$371.88
|
| Rate for Payer: VA VA |
$527.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.02
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,109.36
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,468.11 |
| Max. Negotiated Rate |
$1,898.42 |
| Rate for Payer: Aetna Commercial |
$1,792.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,742.12
|
| Rate for Payer: BCN Commercial |
$1,742.12
|
| Rate for Payer: Cash Price |
$1,687.49
|
| Rate for Payer: Cofinity Commercial |
$1,814.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,687.49
|
| Rate for Payer: Healthscope Commercial |
$1,898.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,792.96
|
| Rate for Payer: Nomi Health Commercial |
$1,729.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,582.02
|
| Rate for Payer: PHP Commercial |
$1,792.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,835.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,468.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,856.24
|
| Rate for Payer: UHC Core |
$1,761.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.02
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$1,544.37
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$272.27 |
| Max. Negotiated Rate |
$1,389.93 |
| Rate for Payer: Aetna Commercial |
$1,312.71
|
| Rate for Payer: Aetna Medicare |
$401.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$482.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$482.62
|
| Rate for Payer: BCBS Complete |
$285.86
|
| Rate for Payer: BCBS MAPPO |
$386.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.63
|
| Rate for Payer: BCN Commercial |
$1,269.63
|
| Rate for Payer: BCN Medicare Advantage |
$386.09
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,328.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.09
|
| Rate for Payer: Healthscope Commercial |
$1,389.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.28
|
| Rate for Payer: Mclaren Medicaid |
$272.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.40
|
| Rate for Payer: Meridian Medicaid |
$285.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$444.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$424.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: PACE Senior Care Partners |
$366.79
|
| Rate for Payer: PACE SWMI |
$386.09
|
| Rate for Payer: PHP Commercial |
$1,312.71
|
| Rate for Payer: PHP Medicare Advantage |
$386.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$272.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,343.60
|
| Rate for Payer: Priority Health Medicare |
$389.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.88
|
| Rate for Payer: Railroad Medicare Medicare |
$386.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,359.05
|
| Rate for Payer: UHC Core |
$1,289.55
|
| Rate for Payer: UHC Exchange |
$386.09
|
| Rate for Payer: UHC Medicaid |
$272.27
|
| Rate for Payer: UHC Medicare Advantage |
$386.09
|
| Rate for Payer: UHCCP Medicaid |
$272.27
|
| Rate for Payer: VA VA |
$386.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.28
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$1,544.37
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,074.88 |
| Max. Negotiated Rate |
$1,389.93 |
| Rate for Payer: Aetna Commercial |
$1,312.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.50
|
| Rate for Payer: BCN Commercial |
$1,275.50
|
| Rate for Payer: Cash Price |
$1,235.50
|
| Rate for Payer: Cofinity Commercial |
$1,328.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,235.50
|
| Rate for Payer: Healthscope Commercial |
$1,389.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,158.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,312.71
|
| Rate for Payer: Nomi Health Commercial |
$1,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,158.28
|
| Rate for Payer: PHP Commercial |
$1,312.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,343.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,359.05
|
| Rate for Payer: UHC Core |
$1,289.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,158.28
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,771.89
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$312.38 |
| Max. Negotiated Rate |
$1,594.70 |
| Rate for Payer: Aetna Commercial |
$1,506.11
|
| Rate for Payer: Aetna Medicare |
$460.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$553.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$553.72
|
| Rate for Payer: BCBS Complete |
$327.98
|
| Rate for Payer: BCBS MAPPO |
$442.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.67
|
| Rate for Payer: BCN Commercial |
$1,456.67
|
| Rate for Payer: BCN Medicare Advantage |
$442.97
|
| Rate for Payer: Cash Price |
$1,417.51
|
| Rate for Payer: Cofinity Commercial |
$1,523.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.97
|
| Rate for Payer: Healthscope Commercial |
$1,594.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,328.92
|
| Rate for Payer: Mclaren Medicaid |
$312.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.12
|
| Rate for Payer: Meridian Medicaid |
$327.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$509.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$487.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,506.11
|
| Rate for Payer: Nomi Health Commercial |
$1,452.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.92
|
| Rate for Payer: PACE Senior Care Partners |
$420.82
|
| Rate for Payer: PACE SWMI |
$442.97
|
| Rate for Payer: PHP Commercial |
$1,506.11
|
| Rate for Payer: PHP Medicare Advantage |
$442.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,541.54
|
| Rate for Payer: Priority Health Medicare |
$447.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,233.24
|
| Rate for Payer: Railroad Medicare Medicare |
$442.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.26
|
| Rate for Payer: UHC Core |
$1,479.53
|
| Rate for Payer: UHC Exchange |
$442.97
|
| Rate for Payer: UHC Medicaid |
$312.38
|
| Rate for Payer: UHC Medicare Advantage |
$442.97
|
| Rate for Payer: UHCCP Medicaid |
$312.38
|
| Rate for Payer: VA VA |
$442.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,328.92
|
|
