|
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
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,544.37
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
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 WO CON
|
Facility
|
IP
|
$1,544.37
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
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 WO W CON
|
Facility
|
IP
|
$2,097.05
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,459.55 |
| Max. Negotiated Rate |
$1,887.35 |
| Rate for Payer: Aetna Commercial |
$1,782.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,731.95
|
| Rate for Payer: BCN Commercial |
$1,731.95
|
| Rate for Payer: Cash Price |
$1,677.64
|
| Rate for Payer: Cofinity Commercial |
$1,803.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.64
|
| Rate for Payer: Healthscope Commercial |
$1,887.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,572.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.49
|
| Rate for Payer: Nomi Health Commercial |
$1,719.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,572.79
|
| Rate for Payer: PHP Commercial |
$1,782.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,824.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,459.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,845.40
|
| Rate for Payer: UHC Core |
$1,751.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,572.79
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,097.05
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$369.71 |
| Max. Negotiated Rate |
$1,887.35 |
| Rate for Payer: Aetna Commercial |
$1,782.49
|
| Rate for Payer: Aetna Medicare |
$545.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$655.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$655.33
|
| Rate for Payer: BCBS Complete |
$388.16
|
| Rate for Payer: BCBS MAPPO |
$524.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.98
|
| Rate for Payer: BCN Commercial |
$1,723.98
|
| Rate for Payer: BCN Medicare Advantage |
$524.26
|
| Rate for Payer: Cash Price |
$1,677.64
|
| Rate for Payer: Cofinity Commercial |
$1,803.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,677.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.26
|
| Rate for Payer: Healthscope Commercial |
$1,887.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,572.79
|
| Rate for Payer: Mclaren Medicaid |
$369.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$550.48
|
| Rate for Payer: Meridian Medicaid |
$388.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$602.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$576.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,782.49
|
| Rate for Payer: Nomi Health Commercial |
$1,719.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,572.79
|
| Rate for Payer: PACE Senior Care Partners |
$498.05
|
| Rate for Payer: PACE SWMI |
$524.26
|
| Rate for Payer: PHP Commercial |
$1,782.49
|
| Rate for Payer: PHP Medicare Advantage |
$524.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,824.43
|
| Rate for Payer: Priority Health Medicare |
$529.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,459.55
|
| Rate for Payer: Railroad Medicare Medicare |
$524.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,845.40
|
| Rate for Payer: UHC Core |
$1,751.04
|
| Rate for Payer: UHC Exchange |
$524.26
|
| Rate for Payer: UHC Medicaid |
$369.71
|
| Rate for Payer: UHC Medicare Advantage |
$524.26
|
| Rate for Payer: UHCCP Medicaid |
$369.71
|
| Rate for Payer: VA VA |
$524.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,572.79
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,408.02
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$979.98 |
| Max. Negotiated Rate |
$1,267.22 |
| Rate for Payer: Aetna Commercial |
$1,196.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.88
|
| Rate for Payer: BCN Commercial |
$1,162.88
|
| Rate for Payer: Cash Price |
$1,126.42
|
| Rate for Payer: Cofinity Commercial |
$1,210.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.42
|
| Rate for Payer: Healthscope Commercial |
$1,267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,196.82
|
| Rate for Payer: Nomi Health Commercial |
$1,154.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.02
|
| Rate for Payer: PHP Commercial |
$1,196.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,224.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.06
|
| Rate for Payer: UHC Core |
$1,175.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.02
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,408.02
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$248.23 |
| Max. Negotiated Rate |
$1,267.22 |
| Rate for Payer: Aetna Commercial |
$1,196.82
|
| Rate for Payer: Aetna Medicare |
$366.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.01
|
| Rate for Payer: BCBS Complete |
$260.62
|
| Rate for Payer: BCBS MAPPO |
$352.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,157.53
|
| Rate for Payer: BCN Commercial |
$1,157.53
|
| Rate for Payer: BCN Medicare Advantage |
$352.00
|
| Rate for Payer: Cash Price |
$1,126.42
|
| Rate for Payer: Cofinity Commercial |
$1,210.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.00
|
| Rate for Payer: Healthscope Commercial |
$1,267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.02
|
| Rate for Payer: Mclaren Medicaid |
$248.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.61
|
| Rate for Payer: Meridian Medicaid |
$260.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$387.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,196.82
|
| Rate for Payer: Nomi Health Commercial |
$1,154.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,056.02
|
| Rate for Payer: PACE Senior Care Partners |
$334.40
|
| Rate for Payer: PACE SWMI |
$352.00
|
| Rate for Payer: PHP Commercial |
$1,196.82
|
| Rate for Payer: PHP Medicare Advantage |
$352.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,224.98
|
| Rate for Payer: Priority Health Medicare |
$355.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.98
|
| Rate for Payer: Railroad Medicare Medicare |
$352.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.06
|
| Rate for Payer: UHC Core |
$1,175.70
|
| Rate for Payer: UHC Exchange |
$352.00
|
| Rate for Payer: UHC Medicaid |
$248.23
|
| Rate for Payer: UHC Medicare Advantage |
$352.00
|
| Rate for Payer: UHCCP Medicaid |
$248.23
|
| Rate for Payer: VA VA |
$352.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.02
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
IP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$805.14 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: BCBS Trust/PPO |
$955.41
|
| Rate for Payer: BCN Commercial |
$955.41
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,006.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.99
|
| Rate for Payer: UHC Core |
$965.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CT CRYOABLATION GUIDANCE
|
Facility
|
OP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000041
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$203.95 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: Aetna Medicare |
$300.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.50
|
| Rate for Payer: BCBS Complete |
$214.13
|
| Rate for Payer: BCBS MAPPO |
$289.20
|
| Rate for Payer: BCBS Trust/PPO |
$951.01
|
| Rate for Payer: BCN Commercial |
$951.01
|
| Rate for Payer: BCN Medicare Advantage |
$289.20
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.20
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: Mclaren Medicaid |
$203.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.66
|
| Rate for Payer: Meridian Medicaid |
$214.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PACE Senior Care Partners |
$274.74
|
| Rate for Payer: PACE SWMI |
$289.20
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: PHP Medicare Advantage |
$289.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,006.42
|
| Rate for Payer: Priority Health Medicare |
$292.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.14
|
| Rate for Payer: Railroad Medicare Medicare |
$289.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.99
|
| Rate for Payer: UHC Core |
$965.94
|
| Rate for Payer: UHC Exchange |
$289.20
|
| Rate for Payer: UHC Medicaid |
$203.95
|
| Rate for Payer: UHC Medicare Advantage |
$289.20
|
| Rate for Payer: UHCCP Medicaid |
$203.95
|
| Rate for Payer: VA VA |
$289.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CT FACIAL W CON
|
Facility
|
IP
|
$1,623.54
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,129.98 |
| Max. Negotiated Rate |
$1,461.19 |
| Rate for Payer: Aetna Commercial |
$1,380.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,340.88
|
| Rate for Payer: BCN Commercial |
$1,340.88
|
| Rate for Payer: Cash Price |
$1,298.83
|
| Rate for Payer: Cofinity Commercial |
$1,396.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.83
|
| Rate for Payer: Healthscope Commercial |
$1,461.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,217.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.01
|
| Rate for Payer: Nomi Health Commercial |
$1,331.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,217.65
|
| Rate for Payer: PHP Commercial |
$1,380.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,412.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,129.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,428.72
|
| Rate for Payer: UHC Core |
$1,355.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,217.65
|
|
|
HC CT FACIAL W CON
|
Facility
|
OP
|
$1,623.54
|
|
|
Service Code
|
CPT 70487
|
| Hospital Charge Code |
35100008
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$286.23 |
| Max. Negotiated Rate |
$1,461.19 |
| Rate for Payer: Aetna Commercial |
$1,380.01
|
| Rate for Payer: Aetna Medicare |
$422.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$507.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$507.36
|
| Rate for Payer: BCBS Complete |
$300.52
|
| Rate for Payer: BCBS MAPPO |
$405.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,334.71
|
| Rate for Payer: BCN Commercial |
$1,334.71
|
| Rate for Payer: BCN Medicare Advantage |
$405.88
|
| Rate for Payer: Cash Price |
$1,298.83
|
| Rate for Payer: Cofinity Commercial |
$1,396.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.88
|
| Rate for Payer: Healthscope Commercial |
$1,461.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,217.65
|
| Rate for Payer: Mclaren Medicaid |
$286.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$426.18
|
| Rate for Payer: Meridian Medicaid |
$300.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$466.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$446.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,380.01
|
| Rate for Payer: Nomi Health Commercial |
$1,331.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,217.65
|
| Rate for Payer: PACE Senior Care Partners |
$385.59
|
| Rate for Payer: PACE SWMI |
$405.88
|
| Rate for Payer: PHP Commercial |
$1,380.01
|
| Rate for Payer: PHP Medicare Advantage |
$405.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,412.48
|
| Rate for Payer: Priority Health Medicare |
$409.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,129.98
|
| Rate for Payer: Railroad Medicare Medicare |
$405.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,428.72
|
| Rate for Payer: UHC Core |
$1,355.66
|
| Rate for Payer: UHC Exchange |
$405.88
|
| Rate for Payer: UHC Medicaid |
$286.23
|
| Rate for Payer: UHC Medicare Advantage |
$405.88
|
| Rate for Payer: UHCCP Medicaid |
$286.23
|
| Rate for Payer: VA VA |
$405.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,217.65
|
|
|
HC CT FACIAL WO CON
|
Facility
|
OP
|
$1,439.10
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$1,295.19 |
| Rate for Payer: Aetna Commercial |
$1,223.23
|
| Rate for Payer: Aetna Medicare |
$374.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.72
|
| Rate for Payer: BCBS Complete |
$266.38
|
| Rate for Payer: BCBS MAPPO |
$359.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.08
|
| Rate for Payer: BCN Commercial |
$1,183.08
|
| Rate for Payer: BCN Medicare Advantage |
$359.77
|
| Rate for Payer: Cash Price |
$1,151.28
|
| Rate for Payer: Cofinity Commercial |
$1,237.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.77
|
| Rate for Payer: Healthscope Commercial |
$1,295.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.33
|
| Rate for Payer: Mclaren Medicaid |
$253.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.76
|
| Rate for Payer: Meridian Medicaid |
$266.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.23
|
| Rate for Payer: Nomi Health Commercial |
$1,180.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.33
|
| Rate for Payer: PACE Senior Care Partners |
$341.79
|
| Rate for Payer: PACE SWMI |
$359.77
|
| Rate for Payer: PHP Commercial |
$1,223.23
|
| Rate for Payer: PHP Medicare Advantage |
$359.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,252.02
|
| Rate for Payer: Priority Health Medicare |
$363.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,001.61
|
| Rate for Payer: Railroad Medicare Medicare |
$359.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.41
|
| Rate for Payer: UHC Core |
$1,201.65
|
| Rate for Payer: UHC Exchange |
$359.77
|
| Rate for Payer: UHC Medicaid |
$253.71
|
| Rate for Payer: UHC Medicare Advantage |
$359.77
|
| Rate for Payer: UHCCP Medicaid |
$253.71
|
| Rate for Payer: VA VA |
$359.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.33
|
|
|
HC CT FACIAL WO CON
|
Facility
|
IP
|
$1,439.10
|
|
|
Service Code
|
CPT 70486
|
| Hospital Charge Code |
35100007
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,001.61 |
| Max. Negotiated Rate |
$1,295.19 |
| Rate for Payer: Aetna Commercial |
$1,223.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.55
|
| Rate for Payer: BCN Commercial |
$1,188.55
|
| Rate for Payer: Cash Price |
$1,151.28
|
| Rate for Payer: Cofinity Commercial |
$1,237.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.28
|
| Rate for Payer: Healthscope Commercial |
$1,295.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.23
|
| Rate for Payer: Nomi Health Commercial |
$1,180.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.33
|
| Rate for Payer: PHP Commercial |
$1,223.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,252.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,001.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.41
|
| Rate for Payer: UHC Core |
$1,201.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.33
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
IP
|
$1,528.66
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,063.95 |
| Max. Negotiated Rate |
$1,375.79 |
| Rate for Payer: Aetna Commercial |
$1,299.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,262.52
|
| Rate for Payer: BCN Commercial |
$1,262.52
|
| Rate for Payer: Cash Price |
$1,222.93
|
| Rate for Payer: Cofinity Commercial |
$1,314.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,222.93
|
| Rate for Payer: Healthscope Commercial |
$1,375.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,146.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,299.36
|
| Rate for Payer: Nomi Health Commercial |
$1,253.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,146.49
|
| Rate for Payer: PHP Commercial |
$1,299.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,329.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,345.22
|
| Rate for Payer: UHC Core |
$1,276.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,146.49
|
|
|
HC CT FACIAL WO W CON
|
Facility
|
OP
|
$1,528.66
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
35101009
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$269.50 |
| Max. Negotiated Rate |
$1,375.79 |
| Rate for Payer: Aetna Commercial |
$1,299.36
|
| Rate for Payer: Aetna Medicare |
$397.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$477.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$477.71
|
| Rate for Payer: BCBS Complete |
$282.95
|
| Rate for Payer: BCBS MAPPO |
$382.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.71
|
| Rate for Payer: BCN Commercial |
$1,256.71
|
| Rate for Payer: BCN Medicare Advantage |
$382.17
|
| Rate for Payer: Cash Price |
$1,222.93
|
| Rate for Payer: Cofinity Commercial |
$1,314.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,222.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.17
|
| Rate for Payer: Healthscope Commercial |
$1,375.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,146.49
|
| Rate for Payer: Mclaren Medicaid |
$269.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.27
|
| Rate for Payer: Meridian Medicaid |
$282.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$420.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,299.36
|
| Rate for Payer: Nomi Health Commercial |
$1,253.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,146.49
|
| Rate for Payer: PACE Senior Care Partners |
$363.06
|
| Rate for Payer: PACE SWMI |
$382.17
|
| Rate for Payer: PHP Commercial |
$1,299.36
|
| Rate for Payer: PHP Medicare Advantage |
$382.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,329.93
|
| Rate for Payer: Priority Health Medicare |
$385.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.95
|
| Rate for Payer: Railroad Medicare Medicare |
$382.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,345.22
|
| Rate for Payer: UHC Core |
$1,276.43
|
| Rate for Payer: UHC Exchange |
$382.17
|
| Rate for Payer: UHC Medicaid |
$269.50
|
| Rate for Payer: UHC Medicare Advantage |
$382.17
|
| Rate for Payer: UHCCP Medicaid |
$269.50
|
| Rate for Payer: VA VA |
$382.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,146.49
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
OP
|
$1,477.52
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$260.49 |
| Max. Negotiated Rate |
$1,329.77 |
| Rate for Payer: Aetna Commercial |
$1,255.89
|
| Rate for Payer: Aetna Medicare |
$384.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$461.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$461.73
|
| Rate for Payer: BCBS Complete |
$273.49
|
| Rate for Payer: BCBS MAPPO |
$369.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,214.67
|
| Rate for Payer: BCN Commercial |
$1,214.67
|
| Rate for Payer: BCN Medicare Advantage |
$369.38
|
| Rate for Payer: Cash Price |
$1,182.02
|
| Rate for Payer: Cofinity Commercial |
$1,270.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.38
|
| Rate for Payer: Healthscope Commercial |
$1,329.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.14
|
| Rate for Payer: Mclaren Medicaid |
$260.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.85
|
| Rate for Payer: Meridian Medicaid |
$273.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,255.89
|
| Rate for Payer: Nomi Health Commercial |
$1,211.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.14
|
| Rate for Payer: PACE Senior Care Partners |
$350.91
|
| Rate for Payer: PACE SWMI |
$369.38
|
| Rate for Payer: PHP Commercial |
$1,255.89
|
| Rate for Payer: PHP Medicare Advantage |
$369.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,285.44
|
| Rate for Payer: Priority Health Medicare |
$373.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.35
|
| Rate for Payer: Railroad Medicare Medicare |
$369.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.22
|
| Rate for Payer: UHC Core |
$1,233.73
|
| Rate for Payer: UHC Exchange |
$369.38
|
| Rate for Payer: UHC Medicaid |
$260.49
|
| Rate for Payer: UHC Medicare Advantage |
$369.38
|
| Rate for Payer: UHCCP Medicaid |
$260.49
|
| Rate for Payer: VA VA |
$369.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.14
|
|
|
HC CT GUIDE JOINT ASP OR INJECTIO
|
Facility
|
IP
|
$1,477.52
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000029
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,028.35 |
| Max. Negotiated Rate |
$1,329.77 |
| Rate for Payer: Aetna Commercial |
$1,255.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.28
|
| Rate for Payer: BCN Commercial |
$1,220.28
|
| Rate for Payer: Cash Price |
$1,182.02
|
| Rate for Payer: Cofinity Commercial |
$1,270.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.02
|
| Rate for Payer: Healthscope Commercial |
$1,329.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,255.89
|
| Rate for Payer: Nomi Health Commercial |
$1,211.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.14
|
| Rate for Payer: PHP Commercial |
$1,255.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,285.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.22
|
| Rate for Payer: UHC Core |
$1,233.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.14
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$1,337.12
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$930.64 |
| Max. Negotiated Rate |
$1,203.41 |
| Rate for Payer: Aetna Commercial |
$1,136.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.33
|
| Rate for Payer: BCN Commercial |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,069.70
|
| Rate for Payer: Cofinity Commercial |
$1,149.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.70
|
| Rate for Payer: Healthscope Commercial |
$1,203.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.55
|
| Rate for Payer: Nomi Health Commercial |
$1,096.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.84
|
| Rate for Payer: PHP Commercial |
$1,136.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,163.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$930.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.67
|
| Rate for Payer: UHC Core |
$1,116.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.84
|
|
|
HC CT GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$1,337.12
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
35000028
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$235.73 |
| Max. Negotiated Rate |
$1,203.41 |
| Rate for Payer: Aetna Commercial |
$1,136.55
|
| Rate for Payer: Aetna Medicare |
$347.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.85
|
| Rate for Payer: BCBS Complete |
$247.50
|
| Rate for Payer: BCBS MAPPO |
$334.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.25
|
| Rate for Payer: BCN Commercial |
$1,099.25
|
| Rate for Payer: BCN Medicare Advantage |
$334.28
|
| Rate for Payer: Cash Price |
$1,069.70
|
| Rate for Payer: Cofinity Commercial |
$1,149.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,069.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.28
|
| Rate for Payer: Healthscope Commercial |
$1,203.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.84
|
| Rate for Payer: Mclaren Medicaid |
$235.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.99
|
| Rate for Payer: Meridian Medicaid |
$247.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$367.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,136.55
|
| Rate for Payer: Nomi Health Commercial |
$1,096.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.84
|
| Rate for Payer: PACE Senior Care Partners |
$317.57
|
| Rate for Payer: PACE SWMI |
$334.28
|
| Rate for Payer: PHP Commercial |
$1,136.55
|
| Rate for Payer: PHP Medicare Advantage |
$334.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,163.29
|
| Rate for Payer: Priority Health Medicare |
$337.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$930.64
|
| Rate for Payer: Railroad Medicare Medicare |
$334.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.67
|
| Rate for Payer: UHC Core |
$1,116.50
|
| Rate for Payer: UHC Exchange |
$334.28
|
| Rate for Payer: UHC Medicaid |
$235.73
|
| Rate for Payer: UHC Medicare Advantage |
$334.28
|
| Rate for Payer: UHCCP Medicaid |
$235.73
|
| Rate for Payer: VA VA |
$334.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.84
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
IP
|
$724.80
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$504.46 |
| Max. Negotiated Rate |
$652.32 |
| Rate for Payer: Aetna Commercial |
$616.08
|
| Rate for Payer: BCBS Trust/PPO |
$598.61
|
| Rate for Payer: BCN Commercial |
$598.61
|
| Rate for Payer: Cash Price |
$579.84
|
| Rate for Payer: Cofinity Commercial |
$623.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.84
|
| Rate for Payer: Healthscope Commercial |
$652.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.08
|
| Rate for Payer: Nomi Health Commercial |
$594.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$543.60
|
| Rate for Payer: PHP Commercial |
$616.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$630.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$504.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.82
|
| Rate for Payer: UHC Core |
$605.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.60
|
|
|
HC CT GUIDE PLACEMENT OF THERAPY FIELDS
|
Facility
|
OP
|
$724.80
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
33300001
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$127.78 |
| Max. Negotiated Rate |
$652.32 |
| Rate for Payer: Aetna Commercial |
$616.08
|
| Rate for Payer: Aetna Medicare |
$188.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$226.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$226.50
|
| Rate for Payer: BCBS Complete |
$134.16
|
| Rate for Payer: BCBS MAPPO |
$181.20
|
| Rate for Payer: BCBS Trust/PPO |
$595.86
|
| Rate for Payer: BCN Commercial |
$595.86
|
| Rate for Payer: BCN Medicare Advantage |
$181.20
|
| Rate for Payer: Cash Price |
$579.84
|
| Rate for Payer: Cofinity Commercial |
$623.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.20
|
| Rate for Payer: Healthscope Commercial |
$652.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.60
|
| Rate for Payer: Mclaren Medicaid |
$127.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.26
|
| Rate for Payer: Meridian Medicaid |
$134.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.08
|
| Rate for Payer: Nomi Health Commercial |
$594.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$543.60
|
| Rate for Payer: PACE Senior Care Partners |
$172.14
|
| Rate for Payer: PACE SWMI |
$181.20
|
| Rate for Payer: PHP Commercial |
$616.08
|
| Rate for Payer: PHP Medicare Advantage |
$181.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$630.58
|
| Rate for Payer: Priority Health Medicare |
$183.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$504.46
|
| Rate for Payer: Railroad Medicare Medicare |
$181.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.82
|
| Rate for Payer: UHC Core |
$605.21
|
| Rate for Payer: UHC Exchange |
$181.20
|
| Rate for Payer: UHC Medicaid |
$127.78
|
| Rate for Payer: UHC Medicare Advantage |
$181.20
|
| Rate for Payer: UHCCP Medicaid |
$127.78
|
| Rate for Payer: VA VA |
$181.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.60
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
IP
|
$1,221.45
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$850.13 |
| Max. Negotiated Rate |
$1,099.31 |
| Rate for Payer: Aetna Commercial |
$1,038.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.80
|
| Rate for Payer: BCN Commercial |
$1,008.80
|
| Rate for Payer: Cash Price |
$977.16
|
| Rate for Payer: Cofinity Commercial |
$1,050.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.16
|
| Rate for Payer: Healthscope Commercial |
$1,099.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.23
|
| Rate for Payer: Nomi Health Commercial |
$1,001.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.09
|
| Rate for Payer: PHP Commercial |
$1,038.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,062.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.88
|
| Rate for Payer: UHC Core |
$1,019.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.09
|
|
|
HC CT GUIDE STEREOTACTIC LOCAL
|
Facility
|
OP
|
$1,221.45
|
|
|
Service Code
|
CPT 77011
|
| Hospital Charge Code |
35000033
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$215.34 |
| Max. Negotiated Rate |
$1,099.31 |
| Rate for Payer: Aetna Commercial |
$1,038.23
|
| Rate for Payer: Aetna Medicare |
$317.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.70
|
| Rate for Payer: BCBS Complete |
$226.09
|
| Rate for Payer: BCBS MAPPO |
$305.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.15
|
| Rate for Payer: BCN Commercial |
$1,004.15
|
| Rate for Payer: BCN Medicare Advantage |
$305.36
|
| Rate for Payer: Cash Price |
$977.16
|
| Rate for Payer: Cofinity Commercial |
$1,050.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.36
|
| Rate for Payer: Healthscope Commercial |
$1,099.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.09
|
| Rate for Payer: Mclaren Medicaid |
$215.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.63
|
| Rate for Payer: Meridian Medicaid |
$226.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.23
|
| Rate for Payer: Nomi Health Commercial |
$1,001.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.09
|
| Rate for Payer: PACE Senior Care Partners |
$290.09
|
| Rate for Payer: PACE SWMI |
$305.36
|
| Rate for Payer: PHP Commercial |
$1,038.23
|
| Rate for Payer: PHP Medicare Advantage |
$305.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,062.66
|
| Rate for Payer: Priority Health Medicare |
$308.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.13
|
| Rate for Payer: Railroad Medicare Medicare |
$305.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.88
|
| Rate for Payer: UHC Core |
$1,019.91
|
| Rate for Payer: UHC Exchange |
$305.36
|
| Rate for Payer: UHC Medicaid |
$215.34
|
| Rate for Payer: UHC Medicare Advantage |
$305.36
|
| Rate for Payer: UHCCP Medicaid |
$215.34
|
| Rate for Payer: VA VA |
$305.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.09
|
|
|
HC CT HEAD ANGIO
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$196.45 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$289.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.21
|
| Rate for Payer: BCBS Complete |
$206.25
|
| Rate for Payer: BCBS MAPPO |
$278.57
|
| Rate for Payer: BCBS Trust/PPO |
$916.04
|
| Rate for Payer: BCN Commercial |
$916.04
|
| Rate for Payer: BCN Medicare Advantage |
$278.57
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.57
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Mclaren Medicaid |
$196.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.50
|
| Rate for Payer: Meridian Medicaid |
$206.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PACE Senior Care Partners |
$264.64
|
| Rate for Payer: PACE SWMI |
$278.57
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: PHP Medicare Advantage |
$278.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Medicare |
$281.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: Railroad Medicare Medicare |
$278.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: UHC Exchange |
$278.57
|
| Rate for Payer: UHC Medicaid |
$196.45
|
| Rate for Payer: UHC Medicare Advantage |
$278.57
|
| Rate for Payer: UHCCP Medicaid |
$196.45
|
| Rate for Payer: VA VA |
$278.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC CT HEAD ANGIO
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$775.53 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: BCBS Trust/PPO |
$920.28
|
| Rate for Payer: BCN Commercial |
$920.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
