|
HC CORDIS CATHETER
|
Facility
|
OP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$176.96 |
| Rate for Payer: Aetna Commercial |
$167.13
|
| Rate for Payer: Aetna Medicare |
$51.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.44
|
| Rate for Payer: BCBS Complete |
$78.65
|
| Rate for Payer: BCBS MAPPO |
$49.16
|
| Rate for Payer: BCBS Trust/PPO |
$161.64
|
| Rate for Payer: BCN Commercial |
$152.87
|
| Rate for Payer: BCN Medicare Advantage |
$49.16
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$169.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.16
|
| Rate for Payer: Healthscope Commercial |
$176.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: PACE Senior Care Partners |
$46.70
|
| Rate for Payer: PACE SWMI |
$49.16
|
| Rate for Payer: PHP Commercial |
$167.13
|
| Rate for Payer: PHP Medicare Advantage |
$49.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: Priority Health HMO/PPO |
$171.06
|
| Rate for Payer: Priority Health Medicare |
$49.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.74
|
| Rate for Payer: Railroad Medicare Medicare |
$49.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.03
|
| Rate for Payer: UHC Core |
$164.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.16
|
| Rate for Payer: UHC Exchange |
$49.16
|
| Rate for Payer: UHC Medicare Advantage |
$49.16
|
| Rate for Payer: VA VA |
$49.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.46
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$196.62
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$176.96 |
| Rate for Payer: Aetna Commercial |
$167.13
|
| Rate for Payer: BCBS Trust/PPO |
$160.50
|
| Rate for Payer: BCN Commercial |
$151.95
|
| Rate for Payer: Cash Price |
$157.30
|
| Rate for Payer: Cofinity Commercial |
$169.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.30
|
| Rate for Payer: Healthscope Commercial |
$176.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.13
|
| Rate for Payer: Nomi Health Commercial |
$161.23
|
| Rate for Payer: PHP Commercial |
$167.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.80
|
| Rate for Payer: Priority Health HMO/PPO |
$171.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.03
|
| Rate for Payer: UHC Core |
$164.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.46
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$37.73
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Exchange |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.48
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$37.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CORN POLLEN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CORN POLLEN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,826.87 |
| Max. Negotiated Rate |
$8,067.97 |
| Rate for Payer: Aetna Commercial |
$7,619.75
|
| Rate for Payer: BCBS Trust/PPO |
$7,317.65
|
| Rate for Payer: BCN Commercial |
$6,927.70
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$7,709.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Healthscope Commercial |
$8,067.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,723.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: PHP Commercial |
$7,619.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health HMO/PPO |
$7,799.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,006.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,888.68
|
| Rate for Payer: UHC Core |
$7,485.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,723.31
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
OP
|
$8,964.41
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,129.05 |
| Max. Negotiated Rate |
$8,067.97 |
| Rate for Payer: Aetna Commercial |
$7,619.75
|
| Rate for Payer: Aetna Medicare |
$2,330.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,801.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,801.38
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$2,241.10
|
| Rate for Payer: BCBS Trust/PPO |
$7,369.64
|
| Rate for Payer: BCN Commercial |
$6,969.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,241.10
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cash Price |
$7,171.53
|
| Rate for Payer: Cofinity Commercial |
$7,709.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,171.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,241.10
|
| Rate for Payer: Healthscope Commercial |
$8,067.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,723.31
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,353.16
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,577.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,619.75
|
| Rate for Payer: Nomi Health Commercial |
$7,350.82
|
| Rate for Payer: PACE Senior Care Partners |
$2,129.05
|
| Rate for Payer: PACE SWMI |
$2,241.10
|
| Rate for Payer: PHP Commercial |
$7,619.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,241.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,826.87
|
| Rate for Payer: Priority Health HMO/PPO |
$7,799.04
|
| Rate for Payer: Priority Health Medicare |
$2,263.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,006.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,241.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,888.68
|
| Rate for Payer: UHC Core |
$7,485.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,241.10
|
| Rate for Payer: UHC Exchange |
$2,241.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,241.10
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$2,241.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,723.31
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.09 |
| Max. Negotiated Rate |
$6,400.75 |
| Rate for Payer: Aetna Commercial |
$6,045.15
|
| Rate for Payer: Aetna Medicare |
$1,849.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,222.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,222.48
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$1,777.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,846.73
|
| Rate for Payer: BCN Commercial |
$5,529.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,777.98
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,116.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,777.98
|
| Rate for Payer: Healthscope Commercial |
$6,400.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,333.96
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,866.88
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,044.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: PACE Senior Care Partners |
$1,689.09
|
| Rate for Payer: PACE SWMI |
$1,777.98
|
| Rate for Payer: PHP Commercial |
$6,045.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,777.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health HMO/PPO |
$6,187.39
|
| Rate for Payer: Priority Health Medicare |
$1,795.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,765.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,777.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,258.51
|
| Rate for Payer: UHC Core |
$5,938.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,777.98
|
| Rate for Payer: UHC Exchange |
$1,777.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,777.98
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$1,777.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,333.96
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,111.94
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,622.76 |
| Max. Negotiated Rate |
$6,400.75 |
| Rate for Payer: Aetna Commercial |
$6,045.15
|
| Rate for Payer: BCBS Trust/PPO |
$5,805.48
|
| Rate for Payer: BCN Commercial |
$5,496.11
|
| Rate for Payer: Cash Price |
$5,689.55
|
| Rate for Payer: Cofinity Commercial |
$6,116.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,689.55
|
| Rate for Payer: Healthscope Commercial |
$6,400.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,045.15
|
| Rate for Payer: Nomi Health Commercial |
$5,831.79
|
| Rate for Payer: PHP Commercial |
$6,045.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,622.76
|
| Rate for Payer: Priority Health HMO/PPO |
$6,187.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,765.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,258.51
|
| Rate for Payer: UHC Core |
$5,938.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,333.96
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,907.74 |
| Max. Negotiated Rate |
$6,795.33 |
| Rate for Payer: Aetna Commercial |
$6,417.81
|
| Rate for Payer: BCBS Trust/PPO |
$6,163.37
|
| Rate for Payer: BCN Commercial |
$5,834.93
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$6,493.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Healthscope Commercial |
$6,795.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,662.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: PHP Commercial |
$6,417.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health HMO/PPO |
$6,568.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,058.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,644.33
|
| Rate for Payer: UHC Core |
$6,304.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,662.78
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,550.37
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,793.21 |
| Max. Negotiated Rate |
$6,795.33 |
| Rate for Payer: Aetna Commercial |
$6,417.81
|
| Rate for Payer: Aetna Medicare |
$1,963.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,359.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,359.49
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$1,887.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,207.16
|
| Rate for Payer: BCN Commercial |
$5,870.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,887.59
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cash Price |
$6,040.30
|
| Rate for Payer: Cofinity Commercial |
$6,493.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,040.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,887.59
|
| Rate for Payer: Healthscope Commercial |
$6,795.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,662.78
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,981.97
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,170.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,417.81
|
| Rate for Payer: Nomi Health Commercial |
$6,191.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,793.21
|
| Rate for Payer: PACE SWMI |
$1,887.59
|
| Rate for Payer: PHP Commercial |
$6,417.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,887.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.74
|
| Rate for Payer: Priority Health HMO/PPO |
$6,568.82
|
| Rate for Payer: Priority Health Medicare |
$1,906.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,058.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,887.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,644.33
|
| Rate for Payer: UHC Core |
$6,304.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,887.59
|
| Rate for Payer: UHC Exchange |
$1,887.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,887.59
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$1,887.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,662.78
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$1,776.50 |
| Max. Negotiated Rate |
$5,703.71 |
| Rate for Payer: Aetna Commercial |
$5,386.84
|
| Rate for Payer: Aetna Medicare |
$1,944.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,337.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,337.50
|
| Rate for Payer: BCBS MAPPO |
$1,870.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,173.27
|
| Rate for Payer: BCN Commercial |
$4,897.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,870.00
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$5,450.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,870.00
|
| Rate for Payer: Healthscope Commercial |
$5,703.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,753.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,963.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,150.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: Nomi Health Commercial |
$5,196.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,776.50
|
| Rate for Payer: PACE SWMI |
$1,870.00
|
| Rate for Payer: PHP Commercial |
$5,386.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,870.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,513.59
|
| Rate for Payer: Priority Health Medicare |
$1,888.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,246.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,870.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,576.96
|
| Rate for Payer: UHC Core |
$5,291.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,870.00
|
| Rate for Payer: UHC Exchange |
$1,870.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,870.00
|
| Rate for Payer: VA VA |
$1,870.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,753.10
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,014.98 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,274.66
|
| Rate for Payer: BCN Commercial |
$1,206.73
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,171.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,358.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,046.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.13
|
| Rate for Payer: UHC Core |
$1,303.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,171.13
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,561.51
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$370.86 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna Medicare |
$405.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.97
|
| Rate for Payer: BCBS Complete |
$624.60
|
| Rate for Payer: BCBS MAPPO |
$390.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.72
|
| Rate for Payer: BCN Commercial |
$1,214.07
|
| Rate for Payer: BCN Medicare Advantage |
$390.38
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.38
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,171.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: PACE Senior Care Partners |
$370.86
|
| Rate for Payer: PACE SWMI |
$390.38
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: PHP Medicare Advantage |
$390.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,358.51
|
| Rate for Payer: Priority Health Medicare |
$394.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,046.21
|
| Rate for Payer: Railroad Medicare Medicare |
$390.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.13
|
| Rate for Payer: UHC Core |
$1,303.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.38
|
| Rate for Payer: UHC Exchange |
$390.38
|
| Rate for Payer: UHC Medicare Advantage |
$390.38
|
| Rate for Payer: VA VA |
$390.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,171.13
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,226.93 |
| Max. Negotiated Rate |
$10,006.52 |
| Rate for Payer: Aetna Commercial |
$9,450.61
|
| Rate for Payer: BCBS Trust/PPO |
$9,075.92
|
| Rate for Payer: BCN Commercial |
$8,592.27
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$9,561.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Healthscope Commercial |
$10,006.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,338.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: Nomi Health Commercial |
$9,117.06
|
| Rate for Payer: PHP Commercial |
$9,450.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: Priority Health HMO/PPO |
$9,672.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,449.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,784.16
|
| Rate for Payer: UHC Core |
$9,283.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,338.77
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$11,118.36
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,640.61 |
| Max. Negotiated Rate |
$10,006.52 |
| Rate for Payer: Aetna Commercial |
$9,450.61
|
| Rate for Payer: Aetna Medicare |
$2,890.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,474.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,474.49
|
| Rate for Payer: BCBS Complete |
$4,447.34
|
| Rate for Payer: BCBS MAPPO |
$2,779.59
|
| Rate for Payer: BCBS Trust/PPO |
$9,140.40
|
| Rate for Payer: BCN Commercial |
$8,644.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,779.59
|
| Rate for Payer: Cash Price |
$8,894.69
|
| Rate for Payer: Cofinity Commercial |
$9,561.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,894.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,779.59
|
| Rate for Payer: Healthscope Commercial |
$10,006.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,338.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,918.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,196.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,450.61
|
| Rate for Payer: Nomi Health Commercial |
$9,117.06
|
| Rate for Payer: PACE Senior Care Partners |
$2,640.61
|
| Rate for Payer: PACE SWMI |
$2,779.59
|
| Rate for Payer: PHP Commercial |
$9,450.61
|
| Rate for Payer: PHP Medicare Advantage |
$2,779.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.93
|
| Rate for Payer: Priority Health HMO/PPO |
$9,672.97
|
| Rate for Payer: Priority Health Medicare |
$2,807.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,449.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,779.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,784.16
|
| Rate for Payer: UHC Core |
$9,283.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,779.59
|
| Rate for Payer: UHC Exchange |
$2,779.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,779.59
|
| Rate for Payer: VA VA |
$2,779.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,338.77
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,641.57 |
| Max. Negotiated Rate |
$3,657.56 |
| Rate for Payer: Aetna Commercial |
$3,454.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,317.41
|
| Rate for Payer: BCN Commercial |
$3,140.63
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,495.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Healthscope Commercial |
$3,657.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,047.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: Nomi Health Commercial |
$3,332.45
|
| Rate for Payer: PHP Commercial |
$3,454.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: Priority Health HMO/PPO |
$3,535.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,722.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,576.28
|
| Rate for Payer: UHC Core |
$3,393.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,047.97
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$4,063.96
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$965.19 |
| Max. Negotiated Rate |
$3,657.56 |
| Rate for Payer: Aetna Commercial |
$3,454.37
|
| Rate for Payer: Aetna Medicare |
$1,056.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,269.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,269.99
|
| Rate for Payer: BCBS Complete |
$1,625.58
|
| Rate for Payer: BCBS MAPPO |
$1,015.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,340.98
|
| Rate for Payer: BCN Commercial |
$3,159.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.99
|
| Rate for Payer: Cash Price |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,495.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,251.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.99
|
| Rate for Payer: Healthscope Commercial |
$3,657.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,047.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,168.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,454.37
|
| Rate for Payer: Nomi Health Commercial |
$3,332.45
|
| Rate for Payer: PACE Senior Care Partners |
$965.19
|
| Rate for Payer: PACE SWMI |
$1,015.99
|
| Rate for Payer: PHP Commercial |
$3,454.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.57
|
| Rate for Payer: Priority Health HMO/PPO |
$3,535.65
|
| Rate for Payer: Priority Health Medicare |
$1,026.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,722.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,015.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,576.28
|
| Rate for Payer: UHC Core |
$3,393.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,015.99
|
| Rate for Payer: UHC Exchange |
$1,015.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.99
|
| Rate for Payer: VA VA |
$1,015.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,047.97
|
|
|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$510.75 |
| Max. Negotiated Rate |
$1,935.46 |
| Rate for Payer: Aetna Commercial |
$1,827.93
|
| Rate for Payer: Aetna Medicare |
$559.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$672.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$672.03
|
| Rate for Payer: BCBS Complete |
$756.79
|
| Rate for Payer: BCBS MAPPO |
$537.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.93
|
| Rate for Payer: BCN Commercial |
$1,672.02
|
| Rate for Payer: BCN Medicare Advantage |
$537.63
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$1,849.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.63
|
| Rate for Payer: Healthscope Commercial |
$1,935.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.88
|
| Rate for Payer: Mclaren Medicaid |
$720.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.51
|
| Rate for Payer: Meridian Medicaid |
$756.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: Nomi Health Commercial |
$1,763.42
|
| Rate for Payer: PACE Senior Care Partners |
$510.75
|
| Rate for Payer: PACE SWMI |
$537.63
|
| Rate for Payer: PHP Commercial |
$1,827.93
|
| Rate for Payer: PHP Medicare Advantage |
$537.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,870.94
|
| Rate for Payer: Priority Health Medicare |
$543.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,440.84
|
| Rate for Payer: Railroad Medicare Medicare |
$537.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,892.45
|
| Rate for Payer: UHC Core |
$1,795.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$537.63
|
| Rate for Payer: UHC Exchange |
$537.63
|
| Rate for Payer: UHC Medicare Advantage |
$537.63
|
| Rate for Payer: UHCCP Medicaid |
$720.70
|
| Rate for Payer: VA VA |
$537.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.88
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,150.51
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,397.83 |
| Max. Negotiated Rate |
$1,935.46 |
| Rate for Payer: Aetna Commercial |
$1,827.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.46
|
| Rate for Payer: BCN Commercial |
$1,661.91
|
| Rate for Payer: Cash Price |
$1,720.41
|
| Rate for Payer: Cofinity Commercial |
$1,849.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.41
|
| Rate for Payer: Healthscope Commercial |
$1,935.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.93
|
| Rate for Payer: Nomi Health Commercial |
$1,763.42
|
| Rate for Payer: PHP Commercial |
$1,827.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,397.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,870.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,440.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,892.45
|
| Rate for Payer: UHC Core |
$1,795.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.88
|
|
