|
HC CT LOWER EXTREM WO CON
|
Facility
|
IP
|
$1,376.45
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200016
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$958.01 |
| Max. Negotiated Rate |
$1,238.81 |
| Rate for Payer: Aetna Commercial |
$1,169.98
|
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.21
|
| Rate for Payer: BCN Commercial |
$1,136.81
|
| Rate for Payer: BCN Commercial |
$1,705.21
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Commercial |
$1,183.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.16
|
| Rate for Payer: Healthscope Commercial |
$1,238.81
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,128.69
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,548.50
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: PHP Commercial |
$1,169.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,796.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,197.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$958.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,437.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.91
|
| Rate for Payer: UHC Core |
$1,149.34
|
| Rate for Payer: UHC Core |
$1,724.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
HC CT LOWER EXTREM WO W CON
|
Facility
|
IP
|
$1,058.24
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200029
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$736.54 |
| Max. Negotiated Rate |
$952.42 |
| Rate for Payer: Aetna Commercial |
$899.50
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: BCBS Trust/PPO |
$874.00
|
| Rate for Payer: BCBS Trust/PPO |
$582.66
|
| Rate for Payer: BCN Commercial |
$874.00
|
| Rate for Payer: BCN Commercial |
$582.66
|
| Rate for Payer: Cash Price |
$846.59
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Cofinity Commercial |
$910.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$846.59
|
| Rate for Payer: Healthscope Commercial |
$952.42
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$793.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.12
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Commercial |
$899.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$931.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$883.63
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$793.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT LOWER EXTREM WO W CON
|
Facility
|
OP
|
$1,058.24
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200029
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.57 |
| Max. Negotiated Rate |
$952.42 |
| Rate for Payer: Aetna Commercial |
$899.50
|
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$183.43
|
| Rate for Payer: Aetna Medicare |
$275.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$330.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$330.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.47
|
| Rate for Payer: BCBS Complete |
$195.88
|
| Rate for Payer: BCBS Complete |
$130.59
|
| Rate for Payer: BCBS MAPPO |
$264.56
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$869.98
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$579.98
|
| Rate for Payer: BCN Commercial |
$869.98
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: BCN Medicare Advantage |
$264.56
|
| Rate for Payer: Cash Price |
$846.59
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$910.09
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$846.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.56
|
| Rate for Payer: Healthscope Commercial |
$952.42
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$793.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$124.38
|
| Rate for Payer: Mclaren Medicaid |
$186.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$277.79
|
| Rate for Payer: Meridian Medicaid |
$195.88
|
| Rate for Payer: Meridian Medicaid |
$130.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$304.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$291.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.50
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: Nomi Health Commercial |
$867.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.12
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE Senior Care Partners |
$251.33
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PACE SWMI |
$264.56
|
| Rate for Payer: PHP Commercial |
$899.50
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$264.56
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.67
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Medicare |
$267.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.02
|
| Rate for Payer: Railroad Medicare Medicare |
$264.56
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$931.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Core |
$883.63
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Exchange |
$264.56
|
| Rate for Payer: UHC Medicaid |
$124.38
|
| Rate for Payer: UHC Medicaid |
$186.57
|
| Rate for Payer: UHC Medicare Advantage |
$264.56
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$186.57
|
| Rate for Payer: UHCCP Medicaid |
$124.38
|
| Rate for Payer: VA VA |
$264.56
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$793.68
|
|
|
HC CT NECK ANGIO
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
35000004
|
|
Hospital Revenue Code
|
350
|
| 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 NECK ANGIO
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
35000004
|
|
Hospital Revenue Code
|
350
|
| 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
|
|
|
HC CT NEEDLE PLACE HEAD AND NECK
|
Facility
|
OP
|
$3,926.47
|
|
|
Service Code
|
CPT 41019
|
| Hospital Charge Code |
36100396
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$692.24 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: Aetna Medicare |
$1,020.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,227.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,227.02
|
| Rate for Payer: BCBS Complete |
$726.79
|
| Rate for Payer: BCBS MAPPO |
$981.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,227.95
|
| Rate for Payer: BCN Commercial |
$3,227.95
|
| Rate for Payer: BCN Medicare Advantage |
$981.62
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.62
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Mclaren Medicaid |
$692.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.70
|
| Rate for Payer: Meridian Medicaid |
$726.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,128.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,079.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PACE Senior Care Partners |
$932.54
|
| Rate for Payer: PACE SWMI |
$981.62
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: PHP Medicare Advantage |
$981.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Medicare |
$991.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: Railroad Medicare Medicare |
$981.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: UHC Exchange |
$981.62
|
| Rate for Payer: UHC Medicaid |
$692.24
|
| Rate for Payer: UHC Medicare Advantage |
$981.62
|
| Rate for Payer: UHCCP Medicaid |
$692.24
|
| Rate for Payer: VA VA |
$981.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC CT NEEDLE PLACE HEAD AND NECK
|
Facility
|
IP
|
$3,926.47
|
|
|
Service Code
|
CPT 41019
|
| Hospital Charge Code |
36100396
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,732.82 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.87
|
| Rate for Payer: BCN Commercial |
$3,242.87
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC CTO CATHETER
|
Facility
|
OP
|
$6,591.31
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,162.05 |
| Max. Negotiated Rate |
$5,932.18 |
| Rate for Payer: Aetna Commercial |
$5,602.61
|
| Rate for Payer: Aetna Medicare |
$1,713.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,059.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,059.78
|
| Rate for Payer: BCBS Complete |
$1,220.05
|
| Rate for Payer: BCBS MAPPO |
$1,647.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,418.72
|
| Rate for Payer: BCN Commercial |
$5,418.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,647.83
|
| Rate for Payer: Cash Price |
$5,273.05
|
| Rate for Payer: Cofinity Commercial |
$5,668.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,273.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,647.83
|
| Rate for Payer: Healthscope Commercial |
$5,932.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,943.48
|
| Rate for Payer: Mclaren Medicaid |
$1,162.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,730.22
|
| Rate for Payer: Meridian Medicaid |
$1,220.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,895.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,812.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,602.61
|
| Rate for Payer: Nomi Health Commercial |
$5,404.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,943.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,565.44
|
| Rate for Payer: PACE SWMI |
$1,647.83
|
| Rate for Payer: PHP Commercial |
$5,602.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,647.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,162.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,734.44
|
| Rate for Payer: Priority Health Medicare |
$1,664.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,587.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,647.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,800.35
|
| Rate for Payer: UHC Core |
$5,503.74
|
| Rate for Payer: UHC Exchange |
$1,647.83
|
| Rate for Payer: UHC Medicaid |
$1,162.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,647.83
|
| Rate for Payer: UHCCP Medicaid |
$1,162.05
|
| Rate for Payer: VA VA |
$1,647.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,943.48
|
|
|
HC CTO CATHETER
|
Facility
|
IP
|
$6,591.31
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,587.55 |
| Max. Negotiated Rate |
$5,932.18 |
| Rate for Payer: Aetna Commercial |
$5,602.61
|
| Rate for Payer: BCBS Trust/PPO |
$5,443.76
|
| Rate for Payer: BCN Commercial |
$5,443.76
|
| Rate for Payer: Cash Price |
$5,273.05
|
| Rate for Payer: Cofinity Commercial |
$5,668.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,273.05
|
| Rate for Payer: Healthscope Commercial |
$5,932.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,943.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,602.61
|
| Rate for Payer: Nomi Health Commercial |
$5,404.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,943.48
|
| Rate for Payer: PHP Commercial |
$5,602.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,734.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,587.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,800.35
|
| Rate for Payer: UHC Core |
$5,503.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,943.48
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
OP
|
$1,611.23
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$284.06 |
| Max. Negotiated Rate |
$1,450.11 |
| Rate for Payer: Aetna Commercial |
$1,369.55
|
| Rate for Payer: Aetna Medicare |
$418.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.51
|
| Rate for Payer: BCBS Complete |
$298.24
|
| Rate for Payer: BCBS MAPPO |
$402.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.59
|
| Rate for Payer: BCN Commercial |
$1,324.59
|
| Rate for Payer: BCN Medicare Advantage |
$402.81
|
| Rate for Payer: Cash Price |
$1,288.98
|
| Rate for Payer: Cofinity Commercial |
$1,385.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.81
|
| Rate for Payer: Healthscope Commercial |
$1,450.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,208.42
|
| Rate for Payer: Mclaren Medicaid |
$284.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.95
|
| Rate for Payer: Meridian Medicaid |
$298.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$463.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,369.55
|
| Rate for Payer: Nomi Health Commercial |
$1,321.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,208.42
|
| Rate for Payer: PACE Senior Care Partners |
$382.67
|
| Rate for Payer: PACE SWMI |
$402.81
|
| Rate for Payer: PHP Commercial |
$1,369.55
|
| Rate for Payer: PHP Medicare Advantage |
$402.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,401.77
|
| Rate for Payer: Priority Health Medicare |
$406.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,121.42
|
| Rate for Payer: Railroad Medicare Medicare |
$402.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,417.88
|
| Rate for Payer: UHC Core |
$1,345.38
|
| Rate for Payer: UHC Exchange |
$402.81
|
| Rate for Payer: UHC Medicaid |
$284.06
|
| Rate for Payer: UHC Medicare Advantage |
$402.81
|
| Rate for Payer: UHCCP Medicaid |
$284.06
|
| Rate for Payer: VA VA |
$402.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,208.42
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
IP
|
$1,611.23
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,121.42 |
| Max. Negotiated Rate |
$1,450.11 |
| Rate for Payer: Aetna Commercial |
$1,369.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.71
|
| Rate for Payer: BCN Commercial |
$1,330.71
|
| Rate for Payer: Cash Price |
$1,288.98
|
| Rate for Payer: Cofinity Commercial |
$1,385.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.98
|
| Rate for Payer: Healthscope Commercial |
$1,450.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,208.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,369.55
|
| Rate for Payer: Nomi Health Commercial |
$1,321.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,208.42
|
| Rate for Payer: PHP Commercial |
$1,369.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,401.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,121.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,417.88
|
| Rate for Payer: UHC Core |
$1,345.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,208.42
|
|
|
HC CT ORBIT WO CON
|
Facility
|
OP
|
$1,464.15
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$258.13 |
| Max. Negotiated Rate |
$1,317.73 |
| Rate for Payer: Aetna Commercial |
$1,244.53
|
| Rate for Payer: Aetna Medicare |
$380.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$457.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$457.55
|
| Rate for Payer: BCBS Complete |
$271.01
|
| Rate for Payer: BCBS MAPPO |
$366.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.68
|
| Rate for Payer: BCN Commercial |
$1,203.68
|
| Rate for Payer: BCN Medicare Advantage |
$366.04
|
| Rate for Payer: Cash Price |
$1,171.32
|
| Rate for Payer: Cofinity Commercial |
$1,259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.04
|
| Rate for Payer: Healthscope Commercial |
$1,317.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.11
|
| Rate for Payer: Mclaren Medicaid |
$258.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$384.34
|
| Rate for Payer: Meridian Medicaid |
$271.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.53
|
| Rate for Payer: Nomi Health Commercial |
$1,200.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.11
|
| Rate for Payer: PACE Senior Care Partners |
$347.74
|
| Rate for Payer: PACE SWMI |
$366.04
|
| Rate for Payer: PHP Commercial |
$1,244.53
|
| Rate for Payer: PHP Medicare Advantage |
$366.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,273.81
|
| Rate for Payer: Priority Health Medicare |
$369.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.05
|
| Rate for Payer: Railroad Medicare Medicare |
$366.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.45
|
| Rate for Payer: UHC Core |
$1,222.57
|
| Rate for Payer: UHC Exchange |
$366.04
|
| Rate for Payer: UHC Medicaid |
$258.13
|
| Rate for Payer: UHC Medicare Advantage |
$366.04
|
| Rate for Payer: UHCCP Medicaid |
$258.13
|
| Rate for Payer: VA VA |
$366.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.11
|
|
|
HC CT ORBIT WO CON
|
Facility
|
IP
|
$1,464.15
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,019.05 |
| Max. Negotiated Rate |
$1,317.73 |
| Rate for Payer: Aetna Commercial |
$1,244.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.24
|
| Rate for Payer: BCN Commercial |
$1,209.24
|
| Rate for Payer: Cash Price |
$1,171.32
|
| Rate for Payer: Cofinity Commercial |
$1,259.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.32
|
| Rate for Payer: Healthscope Commercial |
$1,317.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.53
|
| Rate for Payer: Nomi Health Commercial |
$1,200.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.11
|
| Rate for Payer: PHP Commercial |
$1,244.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,273.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.45
|
| Rate for Payer: UHC Core |
$1,222.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.11
|
|
|
HC CT ORBIT WO W CON
|
Facility
|
OP
|
$1,528.66
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
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 ORBIT WO W CON
|
Facility
|
IP
|
$1,528.66
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
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 PELVIS ANGIO
|
Facility
|
OP
|
$1,988.20
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$350.52 |
| Max. Negotiated Rate |
$1,789.38 |
| Rate for Payer: Aetna Commercial |
$1,689.97
|
| Rate for Payer: Aetna Medicare |
$516.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$621.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$621.31
|
| Rate for Payer: BCBS Complete |
$368.02
|
| Rate for Payer: BCBS MAPPO |
$497.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,634.50
|
| Rate for Payer: BCN Commercial |
$1,634.50
|
| Rate for Payer: BCN Medicare Advantage |
$497.05
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,709.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.05
|
| Rate for Payer: Healthscope Commercial |
$1,789.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,491.15
|
| Rate for Payer: Mclaren Medicaid |
$350.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.90
|
| Rate for Payer: Meridian Medicaid |
$368.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$546.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: PACE Senior Care Partners |
$472.20
|
| Rate for Payer: PACE SWMI |
$497.05
|
| Rate for Payer: PHP Commercial |
$1,689.97
|
| Rate for Payer: PHP Medicare Advantage |
$497.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,729.73
|
| Rate for Payer: Priority Health Medicare |
$502.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.79
|
| Rate for Payer: Railroad Medicare Medicare |
$497.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,749.62
|
| Rate for Payer: UHC Core |
$1,660.15
|
| Rate for Payer: UHC Exchange |
$497.05
|
| Rate for Payer: UHC Medicaid |
$350.52
|
| Rate for Payer: UHC Medicare Advantage |
$497.05
|
| Rate for Payer: UHCCP Medicaid |
$350.52
|
| Rate for Payer: VA VA |
$497.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,491.15
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
IP
|
$1,988.20
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,383.79 |
| Max. Negotiated Rate |
$1,789.38 |
| Rate for Payer: Aetna Commercial |
$1,689.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.05
|
| Rate for Payer: BCN Commercial |
$1,642.05
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Commercial |
$1,709.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,789.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,491.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Nomi Health Commercial |
$1,630.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: PHP Commercial |
$1,689.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,729.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,749.62
|
| Rate for Payer: UHC Core |
$1,660.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,491.15
|
|
|
HC CT PELVIS W CON
|
Facility
|
IP
|
$1,975.52
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,374.96 |
| Max. Negotiated Rate |
$1,777.97 |
| Rate for Payer: Aetna Commercial |
$1,679.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.58
|
| Rate for Payer: BCN Commercial |
$1,631.58
|
| Rate for Payer: Cash Price |
$1,580.42
|
| Rate for Payer: Cofinity Commercial |
$1,698.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.42
|
| Rate for Payer: Healthscope Commercial |
$1,777.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.19
|
| Rate for Payer: Nomi Health Commercial |
$1,619.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,481.64
|
| Rate for Payer: PHP Commercial |
$1,679.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,718.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.46
|
| Rate for Payer: UHC Core |
$1,649.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.64
|
|
|
HC CT PELVIS W CON
|
Facility
|
OP
|
$1,975.52
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$348.28 |
| Max. Negotiated Rate |
$1,777.97 |
| Rate for Payer: Aetna Commercial |
$1,679.19
|
| Rate for Payer: Aetna Medicare |
$513.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$617.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$617.35
|
| Rate for Payer: BCBS Complete |
$365.67
|
| Rate for Payer: BCBS MAPPO |
$493.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,624.07
|
| Rate for Payer: BCN Commercial |
$1,624.07
|
| Rate for Payer: BCN Medicare Advantage |
$493.88
|
| Rate for Payer: Cash Price |
$1,580.42
|
| Rate for Payer: Cofinity Commercial |
$1,698.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.88
|
| Rate for Payer: Healthscope Commercial |
$1,777.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.64
|
| Rate for Payer: Mclaren Medicaid |
$348.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.57
|
| Rate for Payer: Meridian Medicaid |
$365.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$567.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$543.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.19
|
| Rate for Payer: Nomi Health Commercial |
$1,619.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,481.64
|
| Rate for Payer: PACE Senior Care Partners |
$469.19
|
| Rate for Payer: PACE SWMI |
$493.88
|
| Rate for Payer: PHP Commercial |
$1,679.19
|
| Rate for Payer: PHP Medicare Advantage |
$493.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,718.70
|
| Rate for Payer: Priority Health Medicare |
$498.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,374.96
|
| Rate for Payer: Railroad Medicare Medicare |
$493.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.46
|
| Rate for Payer: UHC Core |
$1,649.56
|
| Rate for Payer: UHC Exchange |
$493.88
|
| Rate for Payer: UHC Medicaid |
$348.28
|
| Rate for Payer: UHC Medicare Advantage |
$493.88
|
| Rate for Payer: UHCCP Medicaid |
$348.28
|
| Rate for Payer: VA VA |
$493.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.64
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,448.55
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$255.38 |
| Max. Negotiated Rate |
$1,303.69 |
| Rate for Payer: Aetna Commercial |
$1,231.27
|
| Rate for Payer: Aetna Medicare |
$376.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$452.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$452.67
|
| Rate for Payer: BCBS Complete |
$268.13
|
| Rate for Payer: BCBS MAPPO |
$362.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.85
|
| Rate for Payer: BCN Commercial |
$1,190.85
|
| Rate for Payer: BCN Medicare Advantage |
$362.14
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,245.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.14
|
| Rate for Payer: Healthscope Commercial |
$1,303.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.41
|
| Rate for Payer: Mclaren Medicaid |
$255.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.24
|
| Rate for Payer: Meridian Medicaid |
$268.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$416.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.41
|
| Rate for Payer: PACE Senior Care Partners |
$344.03
|
| Rate for Payer: PACE SWMI |
$362.14
|
| Rate for Payer: PHP Commercial |
$1,231.27
|
| Rate for Payer: PHP Medicare Advantage |
$362.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$255.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,260.24
|
| Rate for Payer: Priority Health Medicare |
$365.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,008.19
|
| Rate for Payer: Railroad Medicare Medicare |
$362.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.72
|
| Rate for Payer: UHC Core |
$1,209.54
|
| Rate for Payer: UHC Exchange |
$362.14
|
| Rate for Payer: UHC Medicaid |
$255.38
|
| Rate for Payer: UHC Medicare Advantage |
$362.14
|
| Rate for Payer: UHCCP Medicaid |
$255.38
|
| Rate for Payer: VA VA |
$362.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.41
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,448.55
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,008.19 |
| Max. Negotiated Rate |
$1,303.69 |
| Rate for Payer: Aetna Commercial |
$1,231.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.36
|
| Rate for Payer: BCN Commercial |
$1,196.36
|
| Rate for Payer: Cash Price |
$1,158.84
|
| Rate for Payer: Cofinity Commercial |
$1,245.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,158.84
|
| Rate for Payer: Healthscope Commercial |
$1,303.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,086.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,231.27
|
| Rate for Payer: Nomi Health Commercial |
$1,187.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,086.41
|
| Rate for Payer: PHP Commercial |
$1,231.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,260.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,008.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,274.72
|
| Rate for Payer: UHC Core |
$1,209.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,086.41
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
OP
|
$2,249.81
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$396.64 |
| Max. Negotiated Rate |
$2,024.83 |
| Rate for Payer: Aetna Commercial |
$1,912.34
|
| Rate for Payer: Aetna Medicare |
$584.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.07
|
| Rate for Payer: BCBS Complete |
$416.44
|
| Rate for Payer: BCBS MAPPO |
$562.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,849.57
|
| Rate for Payer: BCN Commercial |
$1,849.57
|
| Rate for Payer: BCN Medicare Advantage |
$562.45
|
| Rate for Payer: Cash Price |
$1,799.85
|
| Rate for Payer: Cofinity Commercial |
$1,934.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.45
|
| Rate for Payer: Healthscope Commercial |
$2,024.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.36
|
| Rate for Payer: Mclaren Medicaid |
$396.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.58
|
| Rate for Payer: Meridian Medicaid |
$416.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.34
|
| Rate for Payer: Nomi Health Commercial |
$1,844.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.36
|
| Rate for Payer: PACE Senior Care Partners |
$534.33
|
| Rate for Payer: PACE SWMI |
$562.45
|
| Rate for Payer: PHP Commercial |
$1,912.34
|
| Rate for Payer: PHP Medicare Advantage |
$562.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.33
|
| Rate for Payer: Priority Health Medicare |
$568.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.87
|
| Rate for Payer: Railroad Medicare Medicare |
$562.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.83
|
| Rate for Payer: UHC Core |
$1,878.59
|
| Rate for Payer: UHC Exchange |
$562.45
|
| Rate for Payer: UHC Medicaid |
$396.64
|
| Rate for Payer: UHC Medicare Advantage |
$562.45
|
| Rate for Payer: UHCCP Medicaid |
$396.64
|
| Rate for Payer: VA VA |
$562.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.36
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
IP
|
$2,249.81
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,565.87 |
| Max. Negotiated Rate |
$2,024.83 |
| Rate for Payer: Aetna Commercial |
$1,912.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.12
|
| Rate for Payer: BCN Commercial |
$1,858.12
|
| Rate for Payer: Cash Price |
$1,799.85
|
| Rate for Payer: Cofinity Commercial |
$1,934.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.85
|
| Rate for Payer: Healthscope Commercial |
$2,024.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.34
|
| Rate for Payer: Nomi Health Commercial |
$1,844.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.36
|
| Rate for Payer: PHP Commercial |
$1,912.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.83
|
| Rate for Payer: UHC Core |
$1,878.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.36
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$176.95 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: Aetna Medicare |
$260.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.64
|
| Rate for Payer: BCBS Complete |
$185.78
|
| Rate for Payer: BCBS MAPPO |
$250.91
|
| Rate for Payer: BCBS Trust/PPO |
$825.11
|
| Rate for Payer: BCN Commercial |
$825.11
|
| Rate for Payer: BCN Medicare Advantage |
$250.91
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.91
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Mclaren Medicaid |
$176.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.46
|
| Rate for Payer: Meridian Medicaid |
$185.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$276.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Senior Care Partners |
$238.37
|
| Rate for Payer: PACE SWMI |
$250.91
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: PHP Medicare Advantage |
$250.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Medicare |
$253.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: Railroad Medicare Medicare |
$250.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: UHC Exchange |
$250.91
|
| Rate for Payer: UHC Medicaid |
$176.95
|
| Rate for Payer: UHC Medicare Advantage |
$250.91
|
| Rate for Payer: UHCCP Medicaid |
$176.95
|
| Rate for Payer: VA VA |
$250.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.55 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: BCBS Trust/PPO |
$828.92
|
| Rate for Payer: BCN Commercial |
$828.92
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
