|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.29 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: Aetna Medicare |
$206.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.75
|
| Rate for Payer: BCBS Complete |
$317.12
|
| Rate for Payer: BCBS MAPPO |
$198.20
|
| Rate for Payer: BCBS Trust/PPO |
$651.77
|
| Rate for Payer: BCN Commercial |
$616.41
|
| Rate for Payer: BCN Medicare Advantage |
$198.20
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.20
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Nomi Health Commercial |
$650.10
|
| Rate for Payer: PACE Senior Care Partners |
$188.29
|
| Rate for Payer: PACE SWMI |
$198.20
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: PHP Medicare Advantage |
$198.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.33
|
| Rate for Payer: Priority Health HMO/PPO |
$689.74
|
| Rate for Payer: Priority Health Medicare |
$200.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$531.18
|
| Rate for Payer: Railroad Medicare Medicare |
$198.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.67
|
| Rate for Payer: UHC Core |
$662.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.20
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$198.20
|
| Rate for Payer: VA VA |
$198.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
OP
|
$1,532.09
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.87 |
| Max. Negotiated Rate |
$1,378.88 |
| Rate for Payer: Aetna Commercial |
$1,302.28
|
| Rate for Payer: Aetna Medicare |
$398.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.78
|
| Rate for Payer: BCBS Complete |
$612.84
|
| Rate for Payer: BCBS MAPPO |
$383.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.53
|
| Rate for Payer: BCN Commercial |
$1,191.20
|
| Rate for Payer: BCN Medicare Advantage |
$383.02
|
| Rate for Payer: Cash Price |
$1,225.67
|
| Rate for Payer: Cofinity Commercial |
$1,317.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.02
|
| Rate for Payer: Healthscope Commercial |
$1,378.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$440.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.28
|
| Rate for Payer: Nomi Health Commercial |
$1,256.31
|
| Rate for Payer: PACE Senior Care Partners |
$363.87
|
| Rate for Payer: PACE SWMI |
$383.02
|
| Rate for Payer: PHP Commercial |
$1,302.28
|
| Rate for Payer: PHP Medicare Advantage |
$383.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,332.92
|
| Rate for Payer: Priority Health Medicare |
$386.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.50
|
| Rate for Payer: Railroad Medicare Medicare |
$383.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,348.24
|
| Rate for Payer: UHC Core |
$1,279.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.02
|
| Rate for Payer: UHC Exchange |
$383.02
|
| Rate for Payer: UHC Medicare Advantage |
$383.02
|
| Rate for Payer: VA VA |
$383.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.07
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
IP
|
$1,532.09
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$995.86 |
| Max. Negotiated Rate |
$1,378.88 |
| Rate for Payer: Aetna Commercial |
$1,302.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.65
|
| Rate for Payer: BCN Commercial |
$1,184.00
|
| Rate for Payer: Cash Price |
$1,225.67
|
| Rate for Payer: Cofinity Commercial |
$1,317.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.67
|
| Rate for Payer: Healthscope Commercial |
$1,378.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.28
|
| Rate for Payer: Nomi Health Commercial |
$1,256.31
|
| Rate for Payer: PHP Commercial |
$1,302.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,332.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,348.24
|
| Rate for Payer: UHC Core |
$1,279.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.07
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: Aetna Medicare |
$7.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.43
|
| Rate for Payer: BCBS Complete |
$6.90
|
| Rate for Payer: BCBS MAPPO |
$7.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.80
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: BCN Medicare Advantage |
$7.54
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.92
|
| Rate for Payer: Meridian Medicaid |
$6.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.17
|
| Rate for Payer: PACE SWMI |
$7.54
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$7.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Medicare |
$7.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.54
|
| Rate for Payer: UHC Exchange |
$7.54
|
| Rate for Payer: UHC Medicare Advantage |
$7.54
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: VA VA |
$7.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$43.76 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$54.95
|
| Rate for Payer: BCN Commercial |
$52.02
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO |
$58.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15.99 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.04
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$55.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: PACE Senior Care Partners |
$15.99
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO |
$58.57
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Exchange |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$16.83
|
| Rate for Payer: VA VA |
$16.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$232.05 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: BCBS Trust/PPO |
$291.42
|
| Rate for Payer: BCN Commercial |
$275.89
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$310.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.16
|
| Rate for Payer: UHC Core |
$298.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.79 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.56
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS MAPPO |
$89.25
|
| Rate for Payer: BCBS Trust/PPO |
$293.49
|
| Rate for Payer: BCN Commercial |
$277.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.25
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.25
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PACE Senior Care Partners |
$84.79
|
| Rate for Payer: PACE SWMI |
$89.25
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: PHP Medicare Advantage |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$310.59
|
| Rate for Payer: Priority Health Medicare |
$90.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.19
|
| Rate for Payer: Railroad Medicare Medicare |
$89.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.16
|
| Rate for Payer: UHC Core |
$298.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.25
|
| Rate for Payer: UHC Exchange |
$89.25
|
| Rate for Payer: UHC Medicare Advantage |
$89.25
|
| Rate for Payer: VA VA |
$89.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
IP
|
$11,857.50
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,707.38 |
| Max. Negotiated Rate |
$10,671.75 |
| Rate for Payer: Aetna Commercial |
$10,078.88
|
| Rate for Payer: BCBS Trust/PPO |
$9,679.28
|
| Rate for Payer: BCN Commercial |
$9,163.48
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$10,197.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Healthscope Commercial |
$10,671.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,893.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: PHP Commercial |
$10,078.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: Priority Health HMO/PPO |
$10,316.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,944.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,434.60
|
| Rate for Payer: UHC Core |
$9,901.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,893.12
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
OP
|
$11,857.50
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.16 |
| Max. Negotiated Rate |
$10,671.75 |
| Rate for Payer: Aetna Commercial |
$10,078.88
|
| Rate for Payer: Aetna Medicare |
$3,082.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,705.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,705.47
|
| Rate for Payer: BCBS Complete |
$4,743.00
|
| Rate for Payer: BCBS MAPPO |
$2,964.38
|
| Rate for Payer: BCBS Trust/PPO |
$9,748.05
|
| Rate for Payer: BCN Commercial |
$9,219.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,964.38
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$10,197.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,964.38
|
| Rate for Payer: Healthscope Commercial |
$10,671.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,893.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,112.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,409.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: PACE Senior Care Partners |
$2,816.16
|
| Rate for Payer: PACE SWMI |
$2,964.38
|
| Rate for Payer: PHP Commercial |
$10,078.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,964.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: Priority Health HMO/PPO |
$10,316.02
|
| Rate for Payer: Priority Health Medicare |
$2,994.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,944.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,964.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,434.60
|
| Rate for Payer: UHC Core |
$9,901.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,964.38
|
| Rate for Payer: UHC Exchange |
$2,964.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,964.38
|
| Rate for Payer: VA VA |
$2,964.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,893.12
|
|
|
HC CATHETER SINGLE
|
Facility
|
IP
|
$190.56
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.86 |
| Max. Negotiated Rate |
$171.50 |
| Rate for Payer: Aetna Commercial |
$161.98
|
| Rate for Payer: BCBS Trust/PPO |
$155.55
|
| Rate for Payer: BCN Commercial |
$147.26
|
| Rate for Payer: Cash Price |
$152.45
|
| Rate for Payer: Cofinity Commercial |
$163.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.45
|
| Rate for Payer: Healthscope Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.98
|
| Rate for Payer: Nomi Health Commercial |
$156.26
|
| Rate for Payer: PHP Commercial |
$161.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.86
|
| Rate for Payer: Priority Health HMO/PPO |
$165.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.69
|
| Rate for Payer: UHC Core |
$159.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.92
|
|
|
HC CATHETER SINGLE
|
Facility
|
OP
|
$190.56
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.26 |
| Max. Negotiated Rate |
$171.50 |
| Rate for Payer: Aetna Commercial |
$161.98
|
| Rate for Payer: Aetna Medicare |
$49.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.55
|
| Rate for Payer: BCBS Complete |
$76.22
|
| Rate for Payer: BCBS MAPPO |
$47.64
|
| Rate for Payer: BCBS Trust/PPO |
$156.66
|
| Rate for Payer: BCN Commercial |
$148.16
|
| Rate for Payer: BCN Medicare Advantage |
$47.64
|
| Rate for Payer: Cash Price |
$152.45
|
| Rate for Payer: Cofinity Commercial |
$163.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.64
|
| Rate for Payer: Healthscope Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.98
|
| Rate for Payer: Nomi Health Commercial |
$156.26
|
| Rate for Payer: PACE Senior Care Partners |
$45.26
|
| Rate for Payer: PACE SWMI |
$47.64
|
| Rate for Payer: PHP Commercial |
$161.98
|
| Rate for Payer: PHP Medicare Advantage |
$47.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.86
|
| Rate for Payer: Priority Health HMO/PPO |
$165.79
|
| Rate for Payer: Priority Health Medicare |
$48.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.68
|
| Rate for Payer: Railroad Medicare Medicare |
$47.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.69
|
| Rate for Payer: UHC Core |
$159.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.64
|
| Rate for Payer: UHC Exchange |
$47.64
|
| Rate for Payer: UHC Medicare Advantage |
$47.64
|
| Rate for Payer: VA VA |
$47.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.92
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
IP
|
$1,638.63
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,065.11 |
| Max. Negotiated Rate |
$1,474.77 |
| Rate for Payer: Aetna Commercial |
$1,392.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.61
|
| Rate for Payer: BCN Commercial |
$1,266.33
|
| Rate for Payer: Cash Price |
$1,310.90
|
| Rate for Payer: Cofinity Commercial |
$1,409.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,310.90
|
| Rate for Payer: Healthscope Commercial |
$1,474.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,228.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,392.84
|
| Rate for Payer: Nomi Health Commercial |
$1,343.68
|
| Rate for Payer: PHP Commercial |
$1,392.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,425.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,097.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,441.99
|
| Rate for Payer: UHC Core |
$1,368.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,228.97
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
OP
|
$1,638.63
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$389.17 |
| Max. Negotiated Rate |
$1,474.77 |
| Rate for Payer: Aetna Commercial |
$1,392.84
|
| Rate for Payer: Aetna Medicare |
$426.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$512.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$512.07
|
| Rate for Payer: BCBS Complete |
$655.45
|
| Rate for Payer: BCBS MAPPO |
$409.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.12
|
| Rate for Payer: BCN Commercial |
$1,274.03
|
| Rate for Payer: BCN Medicare Advantage |
$409.66
|
| Rate for Payer: Cash Price |
$1,310.90
|
| Rate for Payer: Cofinity Commercial |
$1,409.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,310.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.66
|
| Rate for Payer: Healthscope Commercial |
$1,474.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,228.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$471.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,392.84
|
| Rate for Payer: Nomi Health Commercial |
$1,343.68
|
| Rate for Payer: PACE Senior Care Partners |
$389.17
|
| Rate for Payer: PACE SWMI |
$409.66
|
| Rate for Payer: PHP Commercial |
$1,392.84
|
| Rate for Payer: PHP Medicare Advantage |
$409.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,425.61
|
| Rate for Payer: Priority Health Medicare |
$413.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,097.88
|
| Rate for Payer: Railroad Medicare Medicare |
$409.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,441.99
|
| Rate for Payer: UHC Core |
$1,368.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.66
|
| Rate for Payer: UHC Exchange |
$409.66
|
| Rate for Payer: UHC Medicare Advantage |
$409.66
|
| Rate for Payer: VA VA |
$409.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,228.97
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
IP
|
$7,696.07
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,002.45 |
| Max. Negotiated Rate |
$6,926.46 |
| Rate for Payer: Aetna Commercial |
$6,541.66
|
| Rate for Payer: BCBS Trust/PPO |
$6,282.30
|
| Rate for Payer: BCN Commercial |
$5,947.52
|
| Rate for Payer: Cash Price |
$6,156.86
|
| Rate for Payer: Cofinity Commercial |
$6,618.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,156.86
|
| Rate for Payer: Healthscope Commercial |
$6,926.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,772.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,541.66
|
| Rate for Payer: Nomi Health Commercial |
$6,310.78
|
| Rate for Payer: PHP Commercial |
$6,541.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,002.45
|
| Rate for Payer: Priority Health HMO/PPO |
$6,695.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,156.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,772.54
|
| Rate for Payer: UHC Core |
$6,426.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,772.05
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
OP
|
$7,696.07
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,827.82 |
| Max. Negotiated Rate |
$6,926.46 |
| Rate for Payer: Aetna Commercial |
$6,541.66
|
| Rate for Payer: Aetna Medicare |
$2,000.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,405.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,405.02
|
| Rate for Payer: BCBS Complete |
$3,078.43
|
| Rate for Payer: BCBS MAPPO |
$1,924.02
|
| Rate for Payer: BCBS Trust/PPO |
$6,326.94
|
| Rate for Payer: BCN Commercial |
$5,983.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,924.02
|
| Rate for Payer: Cash Price |
$6,156.86
|
| Rate for Payer: Cofinity Commercial |
$6,618.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,156.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,924.02
|
| Rate for Payer: Healthscope Commercial |
$6,926.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,772.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,020.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,212.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,541.66
|
| Rate for Payer: Nomi Health Commercial |
$6,310.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,827.82
|
| Rate for Payer: PACE SWMI |
$1,924.02
|
| Rate for Payer: PHP Commercial |
$6,541.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,924.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,002.45
|
| Rate for Payer: Priority Health HMO/PPO |
$6,695.58
|
| Rate for Payer: Priority Health Medicare |
$1,943.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,156.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,924.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,772.54
|
| Rate for Payer: UHC Core |
$6,426.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,924.02
|
| Rate for Payer: UHC Exchange |
$1,924.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,924.02
|
| Rate for Payer: VA VA |
$1,924.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,772.05
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
OP
|
$9,710.40
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,306.22 |
| Max. Negotiated Rate |
$8,739.36 |
| Rate for Payer: Aetna Commercial |
$8,253.84
|
| Rate for Payer: Aetna Medicare |
$2,524.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,034.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,034.50
|
| Rate for Payer: BCBS Complete |
$3,884.16
|
| Rate for Payer: BCBS MAPPO |
$2,427.60
|
| Rate for Payer: BCBS Trust/PPO |
$7,982.92
|
| Rate for Payer: BCN Commercial |
$7,549.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,427.60
|
| Rate for Payer: Cash Price |
$7,768.32
|
| Rate for Payer: Cofinity Commercial |
$8,350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,768.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,427.60
|
| Rate for Payer: Healthscope Commercial |
$8,739.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,282.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,548.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,791.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,253.84
|
| Rate for Payer: Nomi Health Commercial |
$7,962.53
|
| Rate for Payer: PACE Senior Care Partners |
$2,306.22
|
| Rate for Payer: PACE SWMI |
$2,427.60
|
| Rate for Payer: PHP Commercial |
$8,253.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,427.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,311.76
|
| Rate for Payer: Priority Health HMO/PPO |
$8,448.05
|
| Rate for Payer: Priority Health Medicare |
$2,451.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,505.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,427.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,545.15
|
| Rate for Payer: UHC Core |
$8,108.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,427.60
|
| Rate for Payer: UHC Exchange |
$2,427.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,427.60
|
| Rate for Payer: VA VA |
$2,427.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,282.80
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
IP
|
$9,710.40
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,311.76 |
| Max. Negotiated Rate |
$8,739.36 |
| Rate for Payer: Aetna Commercial |
$8,253.84
|
| Rate for Payer: BCBS Trust/PPO |
$7,926.60
|
| Rate for Payer: BCN Commercial |
$7,504.20
|
| Rate for Payer: Cash Price |
$7,768.32
|
| Rate for Payer: Cofinity Commercial |
$8,350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,768.32
|
| Rate for Payer: Healthscope Commercial |
$8,739.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,282.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,253.84
|
| Rate for Payer: Nomi Health Commercial |
$7,962.53
|
| Rate for Payer: PHP Commercial |
$8,253.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,311.76
|
| Rate for Payer: Priority Health HMO/PPO |
$8,448.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,505.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,545.15
|
| Rate for Payer: UHC Core |
$8,108.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,282.80
|
|
|
HC CATH LAB STANDBY
|
Facility
|
IP
|
$499.71
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$324.81 |
| Max. Negotiated Rate |
$449.74 |
| Rate for Payer: Aetna Commercial |
$424.75
|
| Rate for Payer: BCBS Trust/PPO |
$407.91
|
| Rate for Payer: BCN Commercial |
$386.18
|
| Rate for Payer: Cash Price |
$399.77
|
| Rate for Payer: Cofinity Commercial |
$429.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.77
|
| Rate for Payer: Healthscope Commercial |
$449.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.75
|
| Rate for Payer: Nomi Health Commercial |
$409.76
|
| Rate for Payer: PHP Commercial |
$424.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.81
|
| Rate for Payer: Priority Health HMO/PPO |
$434.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.74
|
| Rate for Payer: UHC Core |
$417.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.78
|
|
|
HC CATH LAB STANDBY
|
Facility
|
OP
|
$499.71
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$118.68 |
| Max. Negotiated Rate |
$449.74 |
| Rate for Payer: Aetna Commercial |
$424.75
|
| Rate for Payer: Aetna Medicare |
$129.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.16
|
| Rate for Payer: BCBS Complete |
$199.88
|
| Rate for Payer: BCBS MAPPO |
$124.93
|
| Rate for Payer: BCBS Trust/PPO |
$410.81
|
| Rate for Payer: BCN Commercial |
$388.52
|
| Rate for Payer: BCN Medicare Advantage |
$124.93
|
| Rate for Payer: Cash Price |
$399.77
|
| Rate for Payer: Cofinity Commercial |
$429.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.93
|
| Rate for Payer: Healthscope Commercial |
$449.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.75
|
| Rate for Payer: Nomi Health Commercial |
$409.76
|
| Rate for Payer: PACE Senior Care Partners |
$118.68
|
| Rate for Payer: PACE SWMI |
$124.93
|
| Rate for Payer: PHP Commercial |
$424.75
|
| Rate for Payer: PHP Medicare Advantage |
$124.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.81
|
| Rate for Payer: Priority Health HMO/PPO |
$434.75
|
| Rate for Payer: Priority Health Medicare |
$126.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.81
|
| Rate for Payer: Railroad Medicare Medicare |
$124.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.74
|
| Rate for Payer: UHC Core |
$417.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.93
|
| Rate for Payer: UHC Exchange |
$124.93
|
| Rate for Payer: UHC Medicare Advantage |
$124.93
|
| Rate for Payer: VA VA |
$124.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.78
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
OP
|
$153.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.34 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.81
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$125.78
|
| Rate for Payer: BCN Commercial |
$118.96
|
| Rate for Payer: BCN Medicare Advantage |
$38.25
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.25
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: PACE Senior Care Partners |
$36.34
|
| Rate for Payer: PACE SWMI |
$38.25
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: PHP Medicare Advantage |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$133.11
|
| Rate for Payer: Priority Health Medicare |
$38.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.51
|
| Rate for Payer: Railroad Medicare Medicare |
$38.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.64
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.25
|
| Rate for Payer: UHC Exchange |
$38.25
|
| Rate for Payer: UHC Medicare Advantage |
$38.25
|
| Rate for Payer: VA VA |
$38.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
IP
|
$153.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.45 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: BCBS Trust/PPO |
$124.89
|
| Rate for Payer: BCN Commercial |
$118.24
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$133.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.64
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
OP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$174.42 |
| Max. Negotiated Rate |
$660.96 |
| Rate for Payer: Aetna Commercial |
$624.24
|
| Rate for Payer: Aetna Medicare |
$190.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.50
|
| Rate for Payer: BCBS Complete |
$293.76
|
| Rate for Payer: BCBS MAPPO |
$183.60
|
| Rate for Payer: BCBS Trust/PPO |
$603.75
|
| Rate for Payer: BCN Commercial |
$571.00
|
| Rate for Payer: BCN Medicare Advantage |
$183.60
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$631.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$660.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: PACE Senior Care Partners |
$174.42
|
| Rate for Payer: PACE SWMI |
$183.60
|
| Rate for Payer: PHP Commercial |
$624.24
|
| Rate for Payer: PHP Medicare Advantage |
$183.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.36
|
| Rate for Payer: Priority Health HMO/PPO |
$638.93
|
| Rate for Payer: Priority Health Medicare |
$185.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.05
|
| Rate for Payer: Railroad Medicare Medicare |
$183.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.27
|
| Rate for Payer: UHC Core |
$613.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.60
|
| Rate for Payer: UHC Exchange |
$183.60
|
| Rate for Payer: UHC Medicare Advantage |
$183.60
|
| Rate for Payer: VA VA |
$183.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.80
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
IP
|
$734.40
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$477.36 |
| Max. Negotiated Rate |
$660.96 |
| Rate for Payer: Aetna Commercial |
$624.24
|
| Rate for Payer: BCBS Trust/PPO |
$599.49
|
| Rate for Payer: BCN Commercial |
$567.54
|
| Rate for Payer: Cash Price |
$587.52
|
| Rate for Payer: Cofinity Commercial |
$631.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.52
|
| Rate for Payer: Healthscope Commercial |
$660.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.24
|
| Rate for Payer: Nomi Health Commercial |
$602.21
|
| Rate for Payer: PHP Commercial |
$624.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.36
|
| Rate for Payer: Priority Health HMO/PPO |
$638.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.27
|
| Rate for Payer: UHC Core |
$613.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.80
|
|
