|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
OP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$861.79 |
| Max. Negotiated Rate |
$4,399.41 |
| Rate for Payer: Aetna Commercial |
$4,155.00
|
| Rate for Payer: Aetna Medicare |
$1,270.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,527.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,527.57
|
| Rate for Payer: BCBS Complete |
$904.81
|
| Rate for Payer: BCBS MAPPO |
$1,222.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,018.61
|
| Rate for Payer: BCN Commercial |
$4,018.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.06
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Commercial |
$4,203.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.06
|
| Rate for Payer: Healthscope Commercial |
$4,399.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,666.17
|
| Rate for Payer: Mclaren Medicaid |
$861.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.16
|
| Rate for Payer: Meridian Medicaid |
$904.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,405.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,344.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Nomi Health Commercial |
$4,008.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,160.95
|
| Rate for Payer: PACE SWMI |
$1,222.06
|
| Rate for Payer: PHP Commercial |
$4,155.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$861.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,252.76
|
| Rate for Payer: Priority Health Medicare |
$1,234.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,402.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,222.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,301.64
|
| Rate for Payer: UHC Core |
$4,081.67
|
| Rate for Payer: UHC Exchange |
$1,222.06
|
| Rate for Payer: UHC Medicaid |
$861.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.06
|
| Rate for Payer: UHCCP Medicaid |
$861.79
|
| Rate for Payer: VA VA |
$1,222.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,666.17
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
IP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,402.21 |
| Max. Negotiated Rate |
$4,399.41 |
| Rate for Payer: Aetna Commercial |
$4,155.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,037.19
|
| Rate for Payer: BCN Commercial |
$4,037.19
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Commercial |
$4,203.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Healthscope Commercial |
$4,399.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,666.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Nomi Health Commercial |
$4,008.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: PHP Commercial |
$4,155.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,252.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,402.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,301.64
|
| Rate for Payer: UHC Core |
$4,081.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,666.17
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
OP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$245.04 |
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: Aetna Medicare |
$70.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.08
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCBS MAPPO |
$68.07
|
| Rate for Payer: BCBS Trust/PPO |
$223.83
|
| Rate for Payer: BCN Commercial |
$223.83
|
| Rate for Payer: BCN Medicare Advantage |
$68.07
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Commercial |
$234.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.07
|
| Rate for Payer: Healthscope Commercial |
$245.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.20
|
| Rate for Payer: Mclaren Medicaid |
$48.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.47
|
| Rate for Payer: Meridian Medicaid |
$50.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Nomi Health Commercial |
$223.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: PACE Senior Care Partners |
$64.66
|
| Rate for Payer: PACE SWMI |
$68.07
|
| Rate for Payer: PHP Commercial |
$231.43
|
| Rate for Payer: PHP Medicare Advantage |
$68.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$236.87
|
| Rate for Payer: Priority Health Medicare |
$68.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.50
|
| Rate for Payer: Railroad Medicare Medicare |
$68.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.60
|
| Rate for Payer: UHC Core |
$227.35
|
| Rate for Payer: UHC Exchange |
$68.07
|
| Rate for Payer: UHC Medicaid |
$48.00
|
| Rate for Payer: UHC Medicare Advantage |
$68.07
|
| Rate for Payer: UHCCP Medicaid |
$48.00
|
| Rate for Payer: VA VA |
$68.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.20
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
IP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$189.50 |
| Max. Negotiated Rate |
$245.04 |
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: BCBS Trust/PPO |
$224.87
|
| Rate for Payer: BCN Commercial |
$224.87
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Commercial |
$234.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Healthscope Commercial |
$245.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Nomi Health Commercial |
$223.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: PHP Commercial |
$231.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$236.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.60
|
| Rate for Payer: UHC Core |
$227.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.20
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
IP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,818.15 |
| Max. Negotiated Rate |
$25,626.92 |
| Rate for Payer: Aetna Commercial |
$24,203.20
|
| Rate for Payer: BCBS Trust/PPO |
$23,516.97
|
| Rate for Payer: BCN Commercial |
$23,516.97
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Commercial |
$24,487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Healthscope Commercial |
$25,626.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,355.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Nomi Health Commercial |
$23,348.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: PHP Commercial |
$24,203.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,772.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,818.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,057.43
|
| Rate for Payer: UHC Core |
$23,776.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,355.76
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
OP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,020.03 |
| Max. Negotiated Rate |
$25,626.92 |
| Rate for Payer: Aetna Commercial |
$24,203.20
|
| Rate for Payer: Aetna Medicare |
$7,403.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,898.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,898.23
|
| Rate for Payer: BCBS Complete |
$5,270.60
|
| Rate for Payer: BCBS MAPPO |
$7,118.59
|
| Rate for Payer: BCBS Trust/PPO |
$23,408.76
|
| Rate for Payer: BCN Commercial |
$23,408.76
|
| Rate for Payer: BCN Medicare Advantage |
$7,118.59
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Commercial |
$24,487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,118.59
|
| Rate for Payer: Healthscope Commercial |
$25,626.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,355.76
|
| Rate for Payer: Mclaren Medicaid |
$5,020.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,474.52
|
| Rate for Payer: Meridian Medicaid |
$5,270.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,186.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,830.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Nomi Health Commercial |
$23,348.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: PACE Senior Care Partners |
$6,762.66
|
| Rate for Payer: PACE SWMI |
$7,118.59
|
| Rate for Payer: PHP Commercial |
$24,203.20
|
| Rate for Payer: PHP Medicare Advantage |
$7,118.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,020.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,772.68
|
| Rate for Payer: Priority Health Medicare |
$7,189.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,818.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7,118.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,057.43
|
| Rate for Payer: UHC Core |
$23,776.08
|
| Rate for Payer: UHC Exchange |
$7,118.59
|
| Rate for Payer: UHC Medicaid |
$5,020.03
|
| Rate for Payer: UHC Medicare Advantage |
$7,118.59
|
| Rate for Payer: UHCCP Medicaid |
$5,020.03
|
| Rate for Payer: VA VA |
$7,118.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,355.76
|
|
|
HC ELM IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ELM IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
OP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,132.29 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: Aetna Medicare |
$3,144.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,779.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,779.58
|
| Rate for Payer: BCBS Complete |
$2,238.72
|
| Rate for Payer: BCBS MAPPO |
$3,023.66
|
| Rate for Payer: BCBS Trust/PPO |
$9,943.01
|
| Rate for Payer: BCN Commercial |
$9,943.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,023.66
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,023.66
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: Mclaren Medicaid |
$2,132.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,174.85
|
| Rate for Payer: Meridian Medicaid |
$2,238.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,477.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,326.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PACE Senior Care Partners |
$2,872.48
|
| Rate for Payer: PACE SWMI |
$3,023.66
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: PHP Medicare Advantage |
$3,023.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,132.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,522.35
|
| Rate for Payer: Priority Health Medicare |
$3,053.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,417.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3,023.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,643.29
|
| Rate for Payer: UHC Core |
$10,099.03
|
| Rate for Payer: UHC Exchange |
$3,023.66
|
| Rate for Payer: UHC Medicaid |
$2,132.29
|
| Rate for Payer: UHC Medicare Advantage |
$3,023.66
|
| Rate for Payer: UHCCP Medicaid |
$2,132.29
|
| Rate for Payer: VA VA |
$3,023.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
IP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,417.88 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: BCBS Trust/PPO |
$9,988.97
|
| Rate for Payer: BCN Commercial |
$9,988.97
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Nomi Health Commercial |
$9,917.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,522.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,417.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,643.29
|
| Rate for Payer: UHC Core |
$10,099.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,015.31 |
| Max. Negotiated Rate |
$5,192.22 |
| Rate for Payer: Aetna Commercial |
$4,903.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,764.72
|
| Rate for Payer: BCN Commercial |
$4,764.72
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Commercial |
$4,961.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Healthscope Commercial |
$5,192.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,326.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Nomi Health Commercial |
$4,730.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: PHP Commercial |
$4,903.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,019.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,015.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,076.83
|
| Rate for Payer: UHC Core |
$4,817.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,326.85
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,017.10 |
| Max. Negotiated Rate |
$5,192.22 |
| Rate for Payer: Aetna Commercial |
$4,903.76
|
| Rate for Payer: Aetna Medicare |
$1,499.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,802.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,802.85
|
| Rate for Payer: BCBS Complete |
$1,067.87
|
| Rate for Payer: BCBS MAPPO |
$1,442.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,742.80
|
| Rate for Payer: BCN Commercial |
$4,742.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.28
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Commercial |
$4,961.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.28
|
| Rate for Payer: Healthscope Commercial |
$5,192.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,326.85
|
| Rate for Payer: Mclaren Medicaid |
$1,017.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,514.40
|
| Rate for Payer: Meridian Medicaid |
$1,067.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,658.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,586.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Nomi Health Commercial |
$4,730.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,370.17
|
| Rate for Payer: PACE SWMI |
$1,442.28
|
| Rate for Payer: PHP Commercial |
$4,903.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,019.14
|
| Rate for Payer: Priority Health Medicare |
$1,456.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,015.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,076.83
|
| Rate for Payer: UHC Core |
$4,817.22
|
| Rate for Payer: UHC Exchange |
$1,442.28
|
| Rate for Payer: UHC Medicaid |
$1,017.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,442.28
|
| Rate for Payer: UHCCP Medicaid |
$1,017.10
|
| Rate for Payer: VA VA |
$1,442.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,326.85
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,452.82 |
| Max. Negotiated Rate |
$1,878.64 |
| Rate for Payer: Aetna Commercial |
$1,774.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.97
|
| Rate for Payer: BCN Commercial |
$1,723.97
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Commercial |
$1,795.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Healthscope Commercial |
$1,878.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,565.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Nomi Health Commercial |
$1,711.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: PHP Commercial |
$1,774.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,816.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,452.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,836.89
|
| Rate for Payer: UHC Core |
$1,742.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,565.54
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$368.01 |
| Max. Negotiated Rate |
$1,878.64 |
| Rate for Payer: Aetna Commercial |
$1,774.27
|
| Rate for Payer: Aetna Medicare |
$542.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$652.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$652.31
|
| Rate for Payer: BCBS Complete |
$386.37
|
| Rate for Payer: BCBS MAPPO |
$521.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.04
|
| Rate for Payer: BCN Commercial |
$1,716.04
|
| Rate for Payer: BCN Medicare Advantage |
$521.85
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Commercial |
$1,795.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$521.85
|
| Rate for Payer: Healthscope Commercial |
$1,878.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,565.54
|
| Rate for Payer: Mclaren Medicaid |
$368.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$547.94
|
| Rate for Payer: Meridian Medicaid |
$386.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$600.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$574.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Nomi Health Commercial |
$1,711.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: PACE Senior Care Partners |
$495.75
|
| Rate for Payer: PACE SWMI |
$521.85
|
| Rate for Payer: PHP Commercial |
$1,774.27
|
| Rate for Payer: PHP Medicare Advantage |
$521.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,816.02
|
| Rate for Payer: Priority Health Medicare |
$527.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,452.82
|
| Rate for Payer: Railroad Medicare Medicare |
$521.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,836.89
|
| Rate for Payer: UHC Core |
$1,742.96
|
| Rate for Payer: UHC Exchange |
$521.85
|
| Rate for Payer: UHC Medicaid |
$368.01
|
| Rate for Payer: UHC Medicare Advantage |
$521.85
|
| Rate for Payer: UHCCP Medicaid |
$368.01
|
| Rate for Payer: VA VA |
$521.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,565.54
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$664.40 |
| Max. Negotiated Rate |
$859.14 |
| Rate for Payer: Aetna Commercial |
$811.41
|
| Rate for Payer: BCBS Trust/PPO |
$788.40
|
| Rate for Payer: BCN Commercial |
$788.40
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cofinity Commercial |
$820.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$763.68
|
| Rate for Payer: Healthscope Commercial |
$859.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$715.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.41
|
| Rate for Payer: Nomi Health Commercial |
$782.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| Rate for Payer: PHP Commercial |
$811.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$830.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$664.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.05
|
| Rate for Payer: UHC Core |
$797.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$715.95
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$168.30 |
| Max. Negotiated Rate |
$859.14 |
| Rate for Payer: Aetna Commercial |
$811.41
|
| Rate for Payer: Aetna Medicare |
$248.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.31
|
| Rate for Payer: BCBS Complete |
$176.70
|
| Rate for Payer: BCBS MAPPO |
$238.65
|
| Rate for Payer: BCBS Trust/PPO |
$784.78
|
| Rate for Payer: BCN Commercial |
$784.78
|
| Rate for Payer: BCN Medicare Advantage |
$238.65
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cofinity Commercial |
$820.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$763.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.65
|
| Rate for Payer: Healthscope Commercial |
$859.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$715.95
|
| Rate for Payer: Mclaren Medicaid |
$168.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.58
|
| Rate for Payer: Meridian Medicaid |
$176.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$262.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.41
|
| Rate for Payer: Nomi Health Commercial |
$782.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| Rate for Payer: PACE Senior Care Partners |
$226.72
|
| Rate for Payer: PACE SWMI |
$238.65
|
| Rate for Payer: PHP Commercial |
$811.41
|
| Rate for Payer: PHP Medicare Advantage |
$238.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$830.50
|
| Rate for Payer: Priority Health Medicare |
$241.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$664.40
|
| Rate for Payer: Railroad Medicare Medicare |
$238.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$840.05
|
| Rate for Payer: UHC Core |
$797.09
|
| Rate for Payer: UHC Exchange |
$238.65
|
| Rate for Payer: UHC Medicaid |
$168.30
|
| Rate for Payer: UHC Medicare Advantage |
$238.65
|
| Rate for Payer: UHCCP Medicaid |
$168.30
|
| Rate for Payer: VA VA |
$238.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$715.95
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,914.07 |
| Max. Negotiated Rate |
$15,406.13 |
| Rate for Payer: Aetna Commercial |
$14,550.23
|
| Rate for Payer: BCBS Trust/PPO |
$14,137.69
|
| Rate for Payer: BCN Commercial |
$14,137.69
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Commercial |
$14,721.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Healthscope Commercial |
$15,406.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,838.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Nomi Health Commercial |
$14,036.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: PHP Commercial |
$14,550.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14,892.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,914.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,063.77
|
| Rate for Payer: UHC Core |
$14,293.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,838.44
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,017.89 |
| Max. Negotiated Rate |
$15,406.13 |
| Rate for Payer: Aetna Commercial |
$14,550.23
|
| Rate for Payer: Aetna Medicare |
$4,450.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,349.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,349.35
|
| Rate for Payer: BCBS Complete |
$3,168.53
|
| Rate for Payer: BCBS MAPPO |
$4,279.48
|
| Rate for Payer: BCBS Trust/PPO |
$14,072.64
|
| Rate for Payer: BCN Commercial |
$14,072.64
|
| Rate for Payer: BCN Medicare Advantage |
$4,279.48
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Commercial |
$14,721.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,279.48
|
| Rate for Payer: Healthscope Commercial |
$15,406.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,838.44
|
| Rate for Payer: Mclaren Medicaid |
$3,017.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,493.45
|
| Rate for Payer: Meridian Medicaid |
$3,168.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,921.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,707.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Nomi Health Commercial |
$14,036.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: PACE Senior Care Partners |
$4,065.51
|
| Rate for Payer: PACE SWMI |
$4,279.48
|
| Rate for Payer: PHP Commercial |
$14,550.23
|
| Rate for Payer: PHP Medicare Advantage |
$4,279.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,017.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14,892.59
|
| Rate for Payer: Priority Health Medicare |
$4,322.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,914.07
|
| Rate for Payer: Railroad Medicare Medicare |
$4,279.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,063.77
|
| Rate for Payer: UHC Core |
$14,293.46
|
| Rate for Payer: UHC Exchange |
$4,279.48
|
| Rate for Payer: UHC Medicaid |
$3,017.89
|
| Rate for Payer: UHC Medicare Advantage |
$4,279.48
|
| Rate for Payer: UHCCP Medicaid |
$3,017.89
|
| Rate for Payer: VA VA |
$4,279.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,838.44
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,754.08
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,052.84 |
| Max. Negotiated Rate |
$16,878.67 |
| Rate for Payer: Aetna Commercial |
$15,940.97
|
| Rate for Payer: BCBS Trust/PPO |
$15,488.99
|
| Rate for Payer: BCN Commercial |
$15,488.99
|
| Rate for Payer: Cash Price |
$15,003.26
|
| Rate for Payer: Cofinity Commercial |
$16,128.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,003.26
|
| Rate for Payer: Healthscope Commercial |
$16,878.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,065.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,940.97
|
| Rate for Payer: Nomi Health Commercial |
$15,378.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,065.56
|
| Rate for Payer: PHP Commercial |
$15,940.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,316.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,052.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,503.59
|
| Rate for Payer: UHC Core |
$15,659.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,065.56
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,754.08
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,306.34 |
| Max. Negotiated Rate |
$16,878.67 |
| Rate for Payer: Aetna Commercial |
$15,940.97
|
| Rate for Payer: Aetna Medicare |
$4,876.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,860.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,860.65
|
| Rate for Payer: BCBS Complete |
$3,471.38
|
| Rate for Payer: BCBS MAPPO |
$4,688.52
|
| Rate for Payer: BCBS Trust/PPO |
$15,417.73
|
| Rate for Payer: BCN Commercial |
$15,417.73
|
| Rate for Payer: BCN Medicare Advantage |
$4,688.52
|
| Rate for Payer: Cash Price |
$15,003.26
|
| Rate for Payer: Cofinity Commercial |
$16,128.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,003.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,688.52
|
| Rate for Payer: Healthscope Commercial |
$16,878.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,065.56
|
| Rate for Payer: Mclaren Medicaid |
$3,306.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,922.95
|
| Rate for Payer: Meridian Medicaid |
$3,471.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,391.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,157.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,940.97
|
| Rate for Payer: Nomi Health Commercial |
$15,378.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,065.56
|
| Rate for Payer: PACE Senior Care Partners |
$4,454.09
|
| Rate for Payer: PACE SWMI |
$4,688.52
|
| Rate for Payer: PHP Commercial |
$15,940.97
|
| Rate for Payer: PHP Medicare Advantage |
$4,688.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,306.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,316.05
|
| Rate for Payer: Priority Health Medicare |
$4,735.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,052.84
|
| Rate for Payer: Railroad Medicare Medicare |
$4,688.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,503.59
|
| Rate for Payer: UHC Core |
$15,659.66
|
| Rate for Payer: UHC Exchange |
$4,688.52
|
| Rate for Payer: UHC Medicaid |
$3,306.34
|
| Rate for Payer: UHC Medicare Advantage |
$4,688.52
|
| Rate for Payer: UHCCP Medicaid |
$3,306.34
|
| Rate for Payer: VA VA |
$4,688.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,065.56
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
IP
|
$7,781.26
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,415.76 |
| Max. Negotiated Rate |
$7,003.13 |
| Rate for Payer: Aetna Commercial |
$6,614.07
|
| Rate for Payer: BCBS Trust/PPO |
$6,426.54
|
| Rate for Payer: BCN Commercial |
$6,426.54
|
| Rate for Payer: Cash Price |
$6,225.01
|
| Rate for Payer: Cofinity Commercial |
$6,691.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,225.01
|
| Rate for Payer: Healthscope Commercial |
$7,003.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,835.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,614.07
|
| Rate for Payer: Nomi Health Commercial |
$6,380.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,835.94
|
| Rate for Payer: PHP Commercial |
$6,614.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,769.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,415.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,847.51
|
| Rate for Payer: UHC Core |
$6,497.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,835.94
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
OP
|
$7,781.26
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,371.84 |
| Max. Negotiated Rate |
$7,003.13 |
| Rate for Payer: Aetna Commercial |
$6,614.07
|
| Rate for Payer: Aetna Medicare |
$2,023.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,431.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,431.64
|
| Rate for Payer: BCBS Complete |
$1,440.31
|
| Rate for Payer: BCBS MAPPO |
$1,945.32
|
| Rate for Payer: BCBS Trust/PPO |
$6,396.97
|
| Rate for Payer: BCN Commercial |
$6,396.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.32
|
| Rate for Payer: Cash Price |
$6,225.01
|
| Rate for Payer: Cofinity Commercial |
$6,691.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,225.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.32
|
| Rate for Payer: Healthscope Commercial |
$7,003.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,835.94
|
| Rate for Payer: Mclaren Medicaid |
$1,371.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.58
|
| Rate for Payer: Meridian Medicaid |
$1,440.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,139.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,614.07
|
| Rate for Payer: Nomi Health Commercial |
$6,380.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,835.94
|
| Rate for Payer: PACE Senior Care Partners |
$1,848.05
|
| Rate for Payer: PACE SWMI |
$1,945.32
|
| Rate for Payer: PHP Commercial |
$6,614.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,371.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,769.70
|
| Rate for Payer: Priority Health Medicare |
$1,964.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,415.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,847.51
|
| Rate for Payer: UHC Core |
$6,497.35
|
| Rate for Payer: UHC Exchange |
$1,945.32
|
| Rate for Payer: UHC Medicaid |
$1,371.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,945.32
|
| Rate for Payer: UHCCP Medicaid |
$1,371.84
|
| Rate for Payer: VA VA |
$1,945.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,835.94
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.43 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: Aetna Medicare |
$487.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$585.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$585.70
|
| Rate for Payer: BCBS Complete |
$346.92
|
| Rate for Payer: BCBS MAPPO |
$468.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.82
|
| Rate for Payer: BCN Commercial |
$1,540.82
|
| Rate for Payer: BCN Medicare Advantage |
$468.56
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.56
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Mclaren Medicaid |
$330.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.99
|
| Rate for Payer: Meridian Medicaid |
$346.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$538.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$515.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.69
|
| Rate for Payer: PACE Senior Care Partners |
$445.13
|
| Rate for Payer: PACE SWMI |
$468.56
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: PHP Medicare Advantage |
$468.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$330.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,630.60
|
| Rate for Payer: Priority Health Medicare |
$473.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,304.48
|
| Rate for Payer: Railroad Medicare Medicare |
$468.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.34
|
| Rate for Payer: UHC Core |
$1,565.00
|
| Rate for Payer: UHC Exchange |
$468.56
|
| Rate for Payer: UHC Medicaid |
$330.43
|
| Rate for Payer: UHC Medicare Advantage |
$468.56
|
| Rate for Payer: UHCCP Medicaid |
$330.43
|
| Rate for Payer: VA VA |
$468.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
IP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,304.48 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,547.94
|
| Rate for Payer: BCN Commercial |
$1,547.94
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,405.69
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,630.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,304.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.34
|
| Rate for Payer: UHC Core |
$1,565.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
IP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.81 |
| Max. Negotiated Rate |
$144.59 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: BCBS Trust/PPO |
$132.68
|
| Rate for Payer: BCN Commercial |
$132.68
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$144.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.49
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
