|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna Medicare |
$16.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.33
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS MAPPO |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$48.09
|
| Rate for Payer: BCN Commercial |
$48.09
|
| Rate for Payer: BCN Medicare Advantage |
$15.46
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.46
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PACE Senior Care Partners |
$14.69
|
| Rate for Payer: PACE SWMI |
$15.46
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.81
|
| Rate for Payer: Priority Health Medicare |
$15.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.46
|
| Rate for Payer: UHC Medicare Advantage |
$15.93
|
| Rate for Payer: VA VA |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$37.72 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
IP
|
$105.11
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$81.23
|
| Rate for Payer: BCN Commercial |
$81.23
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.34
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.50
|
| Rate for Payer: UHC Core |
$87.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$105.11
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Aetna Commercial |
$89.34
|
| Rate for Payer: Aetna Medicare |
$27.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.85
|
| Rate for Payer: BCBS Complete |
$42.04
|
| Rate for Payer: BCBS MAPPO |
$26.28
|
| Rate for Payer: BCBS Trust/PPO |
$81.72
|
| Rate for Payer: BCN Commercial |
$81.72
|
| Rate for Payer: BCN Medicare Advantage |
$26.28
|
| Rate for Payer: Cash Price |
$84.09
|
| Rate for Payer: Cofinity Commercial |
$90.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.28
|
| Rate for Payer: Healthscope Commercial |
$94.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.34
|
| Rate for Payer: PACE Senior Care Partners |
$24.96
|
| Rate for Payer: PACE SWMI |
$26.28
|
| Rate for Payer: PHP Commercial |
$89.34
|
| Rate for Payer: PHP Medicare Advantage |
$26.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.45
|
| Rate for Payer: Priority Health Medicare |
$26.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.11
|
| Rate for Payer: Railroad Medicare Medicare |
$26.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.50
|
| Rate for Payer: UHC Core |
$87.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.28
|
| Rate for Payer: UHC Medicare Advantage |
$27.07
|
| Rate for Payer: VA VA |
$26.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.83
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$16.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.31
|
| Rate for Payer: BCBS Complete |
$12.92
|
| Rate for Payer: BCBS MAPPO |
$16.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$50.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Meridian Medicaid |
$12.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$16.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.25
|
| Rate for Payer: UHC Medicare Advantage |
$16.74
|
| Rate for Payer: VA VA |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.23
|
| Rate for Payer: BCN Commercial |
$50.23
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.60 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$172.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.19
|
| Rate for Payer: BCBS Complete |
$147.63
|
| Rate for Payer: BCBS MAPPO |
$165.75
|
| Rate for Payer: BCBS Trust/PPO |
$515.48
|
| Rate for Payer: BCN Commercial |
$515.48
|
| Rate for Payer: BCN Medicare Advantage |
$165.75
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.75
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Mclaren Medicaid |
$140.60
|
| Rate for Payer: Meridian Medicaid |
$147.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PACE Senior Care Partners |
$157.46
|
| Rate for Payer: PACE SWMI |
$165.75
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$165.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.81
|
| Rate for Payer: Priority Health Medicare |
$165.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$404.36
|
| Rate for Payer: Railroad Medicare Medicare |
$165.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.75
|
| Rate for Payer: UHC Medicare Advantage |
$170.72
|
| Rate for Payer: VA VA |
$165.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$404.36 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: BCBS Trust/PPO |
$512.37
|
| Rate for Payer: BCN Commercial |
$512.37
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$404.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
IP
|
$565.20
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$344.72 |
| Max. Negotiated Rate |
$508.68 |
| Rate for Payer: Aetna Commercial |
$480.42
|
| Rate for Payer: BCBS Trust/PPO |
$436.79
|
| Rate for Payer: BCN Commercial |
$436.79
|
| Rate for Payer: Cash Price |
$452.16
|
| Rate for Payer: Cofinity Commercial |
$486.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.16
|
| Rate for Payer: Healthscope Commercial |
$508.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.42
|
| Rate for Payer: PHP Commercial |
$480.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.38
|
| Rate for Payer: UHC Core |
$471.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.90
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
OP
|
$565.20
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$134.24 |
| Max. Negotiated Rate |
$508.68 |
| Rate for Payer: Aetna Commercial |
$480.42
|
| Rate for Payer: Aetna Medicare |
$146.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.62
|
| Rate for Payer: BCBS Complete |
$226.08
|
| Rate for Payer: BCBS MAPPO |
$141.30
|
| Rate for Payer: BCBS Trust/PPO |
$439.44
|
| Rate for Payer: BCN Commercial |
$439.44
|
| Rate for Payer: BCN Medicare Advantage |
$141.30
|
| Rate for Payer: Cash Price |
$452.16
|
| Rate for Payer: Cofinity Commercial |
$486.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.30
|
| Rate for Payer: Healthscope Commercial |
$508.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.42
|
| Rate for Payer: PACE Senior Care Partners |
$134.24
|
| Rate for Payer: PACE SWMI |
$141.30
|
| Rate for Payer: PHP Commercial |
$480.42
|
| Rate for Payer: PHP Medicare Advantage |
$141.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.72
|
| Rate for Payer: Priority Health Medicare |
$141.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.72
|
| Rate for Payer: Railroad Medicare Medicare |
$141.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.38
|
| Rate for Payer: UHC Core |
$471.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.30
|
| Rate for Payer: UHC Medicare Advantage |
$145.54
|
| Rate for Payer: VA VA |
$141.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.90
|
|
|
HC GUIDANT / ABBOTT PERIPHERAL ST
|
Facility
|
OP
|
$2,989.24
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$709.94 |
| Max. Negotiated Rate |
$2,690.32 |
| Rate for Payer: Aetna Commercial |
$2,540.85
|
| Rate for Payer: Aetna Medicare |
$777.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$934.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$934.14
|
| Rate for Payer: BCBS Complete |
$1,195.70
|
| Rate for Payer: BCBS MAPPO |
$747.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,324.13
|
| Rate for Payer: BCN Commercial |
$2,324.13
|
| Rate for Payer: BCN Medicare Advantage |
$747.31
|
| Rate for Payer: Cash Price |
$2,391.39
|
| Rate for Payer: Cofinity Commercial |
$2,570.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.31
|
| Rate for Payer: Healthscope Commercial |
$2,690.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$784.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$859.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,540.85
|
| Rate for Payer: PACE Senior Care Partners |
$709.94
|
| Rate for Payer: PACE SWMI |
$747.31
|
| Rate for Payer: PHP Commercial |
$2,540.85
|
| Rate for Payer: PHP Medicare Advantage |
$747.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,600.64
|
| Rate for Payer: Priority Health Medicare |
$747.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,823.14
|
| Rate for Payer: Railroad Medicare Medicare |
$747.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,630.53
|
| Rate for Payer: UHC Core |
$2,496.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$747.31
|
| Rate for Payer: UHC Medicare Advantage |
$769.73
|
| Rate for Payer: VA VA |
$747.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.93
|
|
|
HC GUIDANT / ABBOTT PERIPHERAL ST
|
Facility
|
IP
|
$2,989.24
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,823.14 |
| Max. Negotiated Rate |
$2,690.32 |
| Rate for Payer: Aetna Commercial |
$2,540.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,310.08
|
| Rate for Payer: BCN Commercial |
$2,310.08
|
| Rate for Payer: Cash Price |
$2,391.39
|
| Rate for Payer: Cofinity Commercial |
$2,570.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.39
|
| Rate for Payer: Healthscope Commercial |
$2,690.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,540.85
|
| Rate for Payer: PHP Commercial |
$2,540.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,600.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,823.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,630.53
|
| Rate for Payer: UHC Core |
$2,496.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.93
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
IP
|
$5,707.26
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,480.86 |
| Max. Negotiated Rate |
$5,136.53 |
| Rate for Payer: Aetna Commercial |
$4,851.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,410.57
|
| Rate for Payer: BCN Commercial |
$4,410.57
|
| Rate for Payer: Cash Price |
$4,565.81
|
| Rate for Payer: Cofinity Commercial |
$4,908.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,565.81
|
| Rate for Payer: Healthscope Commercial |
$5,136.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,280.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,851.17
|
| Rate for Payer: PHP Commercial |
$4,851.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,995.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,965.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,480.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,022.39
|
| Rate for Payer: UHC Core |
$4,765.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,280.44
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
OP
|
$5,707.26
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,355.47 |
| Max. Negotiated Rate |
$5,136.53 |
| Rate for Payer: Aetna Commercial |
$4,851.17
|
| Rate for Payer: Aetna Medicare |
$1,483.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,783.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,783.52
|
| Rate for Payer: BCBS Complete |
$2,282.90
|
| Rate for Payer: BCBS MAPPO |
$1,426.82
|
| Rate for Payer: BCBS Trust/PPO |
$4,437.39
|
| Rate for Payer: BCN Commercial |
$4,437.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,426.82
|
| Rate for Payer: Cash Price |
$4,565.81
|
| Rate for Payer: Cofinity Commercial |
$4,908.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,565.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,426.82
|
| Rate for Payer: Healthscope Commercial |
$5,136.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,280.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,498.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,640.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,851.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,355.47
|
| Rate for Payer: PACE SWMI |
$1,426.82
|
| Rate for Payer: PHP Commercial |
$4,851.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,426.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,995.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,965.32
|
| Rate for Payer: Priority Health Medicare |
$1,426.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,480.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,426.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,022.39
|
| Rate for Payer: UHC Core |
$4,765.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,426.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,469.62
|
| Rate for Payer: VA VA |
$1,426.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,280.44
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
OP
|
$10,150.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,410.62 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Aetna Commercial |
$8,627.50
|
| Rate for Payer: Aetna Medicare |
$2,639.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,171.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,171.88
|
| Rate for Payer: BCBS Complete |
$4,060.00
|
| Rate for Payer: BCBS MAPPO |
$2,537.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,891.62
|
| Rate for Payer: BCN Commercial |
$7,891.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,537.50
|
| Rate for Payer: Cash Price |
$8,120.00
|
| Rate for Payer: Cofinity Commercial |
$8,729.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,537.50
|
| Rate for Payer: Healthscope Commercial |
$9,135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,612.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,664.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,918.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,627.50
|
| Rate for Payer: PACE Senior Care Partners |
$2,410.62
|
| Rate for Payer: PACE SWMI |
$2,537.50
|
| Rate for Payer: PHP Commercial |
$8,627.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,537.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,830.50
|
| Rate for Payer: Priority Health Medicare |
$2,537.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,190.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,537.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,932.00
|
| Rate for Payer: UHC Core |
$8,475.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,537.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,613.62
|
| Rate for Payer: VA VA |
$2,537.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,612.50
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
IP
|
$10,150.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,190.48 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Aetna Commercial |
$8,627.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,843.92
|
| Rate for Payer: BCN Commercial |
$7,843.92
|
| Rate for Payer: Cash Price |
$8,120.00
|
| Rate for Payer: Cofinity Commercial |
$8,729.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,120.00
|
| Rate for Payer: Healthscope Commercial |
$9,135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,612.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,627.50
|
| Rate for Payer: PHP Commercial |
$8,627.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,830.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,190.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,932.00
|
| Rate for Payer: UHC Core |
$8,475.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,612.50
|
|
|
HC GUIDANT PERIPHERAL BALLOON
|
Facility
|
IP
|
$720.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$439.13 |
| Max. Negotiated Rate |
$648.00 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: BCBS Trust/PPO |
$556.42
|
| Rate for Payer: BCN Commercial |
$556.42
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.00
|
| Rate for Payer: Healthscope Commercial |
$648.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.00
|
| Rate for Payer: PHP Commercial |
$612.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.60
|
| Rate for Payer: UHC Core |
$601.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.00
|
|
|
HC GUIDANT PERIPHERAL BALLOON
|
Facility
|
OP
|
$720.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$171.00 |
| Max. Negotiated Rate |
$648.00 |
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: Aetna Medicare |
$187.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.00
|
| Rate for Payer: BCBS Complete |
$288.00
|
| Rate for Payer: BCBS MAPPO |
$180.00
|
| Rate for Payer: BCBS Trust/PPO |
$559.80
|
| Rate for Payer: BCN Commercial |
$559.80
|
| Rate for Payer: BCN Medicare Advantage |
$180.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$648.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.00
|
| Rate for Payer: PACE Senior Care Partners |
$171.00
|
| Rate for Payer: PACE SWMI |
$180.00
|
| Rate for Payer: PHP Commercial |
$612.00
|
| Rate for Payer: PHP Medicare Advantage |
$180.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.40
|
| Rate for Payer: Priority Health Medicare |
$180.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.13
|
| Rate for Payer: Railroad Medicare Medicare |
$180.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.60
|
| Rate for Payer: UHC Core |
$601.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.00
|
| Rate for Payer: UHC Medicare Advantage |
$185.40
|
| Rate for Payer: VA VA |
$180.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.00
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$12,993.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,924.43 |
| Max. Negotiated Rate |
$11,693.70 |
| Rate for Payer: Aetna Commercial |
$11,044.05
|
| Rate for Payer: BCBS Trust/PPO |
$10,040.99
|
| Rate for Payer: BCN Commercial |
$10,040.99
|
| Rate for Payer: Cash Price |
$10,394.40
|
| Rate for Payer: Cofinity Commercial |
$11,173.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,394.40
|
| Rate for Payer: Healthscope Commercial |
$11,693.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,744.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,044.05
|
| Rate for Payer: PHP Commercial |
$11,044.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,095.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,303.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,924.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,433.84
|
| Rate for Payer: UHC Core |
$10,849.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,744.75
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
OP
|
$12,993.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,085.84 |
| Max. Negotiated Rate |
$11,693.70 |
| Rate for Payer: Aetna Commercial |
$11,044.05
|
| Rate for Payer: Aetna Medicare |
$3,378.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,060.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,060.31
|
| Rate for Payer: BCBS Complete |
$5,197.20
|
| Rate for Payer: BCBS MAPPO |
$3,248.25
|
| Rate for Payer: BCBS Trust/PPO |
$10,102.06
|
| Rate for Payer: BCN Commercial |
$10,102.06
|
| Rate for Payer: BCN Medicare Advantage |
$3,248.25
|
| Rate for Payer: Cash Price |
$10,394.40
|
| Rate for Payer: Cofinity Commercial |
$11,173.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,394.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,248.25
|
| Rate for Payer: Healthscope Commercial |
$11,693.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,744.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,410.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,735.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,044.05
|
| Rate for Payer: PACE Senior Care Partners |
$3,085.84
|
| Rate for Payer: PACE SWMI |
$3,248.25
|
| Rate for Payer: PHP Commercial |
$11,044.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,248.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,095.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,303.91
|
| Rate for Payer: Priority Health Medicare |
$3,248.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,924.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,248.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,433.84
|
| Rate for Payer: UHC Core |
$10,849.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,248.25
|
| Rate for Payer: UHC Medicare Advantage |
$3,345.70
|
| Rate for Payer: VA VA |
$3,248.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,744.75
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
IP
|
$524.10
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$319.65 |
| Max. Negotiated Rate |
$471.69 |
| Rate for Payer: Aetna Commercial |
$445.48
|
| Rate for Payer: BCBS Trust/PPO |
$405.02
|
| Rate for Payer: BCN Commercial |
$405.02
|
| Rate for Payer: Cash Price |
$419.28
|
| Rate for Payer: Cofinity Commercial |
$450.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.28
|
| Rate for Payer: Healthscope Commercial |
$471.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.48
|
| Rate for Payer: PHP Commercial |
$445.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.21
|
| Rate for Payer: UHC Core |
$437.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.08
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
OP
|
$524.10
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$471.69 |
| Rate for Payer: Aetna Commercial |
$445.48
|
| Rate for Payer: Aetna Medicare |
$136.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.78
|
| Rate for Payer: BCBS Complete |
$209.64
|
| Rate for Payer: BCBS MAPPO |
$131.02
|
| Rate for Payer: BCBS Trust/PPO |
$407.49
|
| Rate for Payer: BCN Commercial |
$407.49
|
| Rate for Payer: BCN Medicare Advantage |
$131.02
|
| Rate for Payer: Cash Price |
$419.28
|
| Rate for Payer: Cofinity Commercial |
$450.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.02
|
| Rate for Payer: Healthscope Commercial |
$471.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.48
|
| Rate for Payer: PACE Senior Care Partners |
$124.47
|
| Rate for Payer: PACE SWMI |
$131.02
|
| Rate for Payer: PHP Commercial |
$445.48
|
| Rate for Payer: PHP Medicare Advantage |
$131.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$455.97
|
| Rate for Payer: Priority Health Medicare |
$131.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.65
|
| Rate for Payer: Railroad Medicare Medicare |
$131.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.21
|
| Rate for Payer: UHC Core |
$437.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.02
|
| Rate for Payer: UHC Medicare Advantage |
$134.96
|
| Rate for Payer: VA VA |
$131.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.08
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
IP
|
$1,718.55
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,048.14 |
| Max. Negotiated Rate |
$1,546.70 |
| Rate for Payer: Aetna Commercial |
$1,460.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.10
|
| Rate for Payer: BCN Commercial |
$1,328.10
|
| Rate for Payer: Cash Price |
$1,374.84
|
| Rate for Payer: Cofinity Commercial |
$1,477.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,374.84
|
| Rate for Payer: Healthscope Commercial |
$1,546.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,288.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,460.77
|
| Rate for Payer: PHP Commercial |
$1,460.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,202.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,495.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,048.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,512.32
|
| Rate for Payer: UHC Core |
$1,434.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,288.91
|
|
