|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$144.59 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.20
|
| Rate for Payer: BCBS Complete |
$29.74
|
| Rate for Payer: BCBS MAPPO |
$40.16
|
| Rate for Payer: BCBS Trust/PPO |
$132.07
|
| Rate for Payer: BCN Commercial |
$132.07
|
| Rate for Payer: BCN Medicare Advantage |
$40.16
|
| 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: Health Alliance Plan Medicare Advantage |
$40.16
|
| Rate for Payer: Healthscope Commercial |
$144.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Mclaren Medicaid |
$28.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.17
|
| Rate for Payer: Meridian Medicaid |
$29.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.18
|
| 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: PACE Senior Care Partners |
$38.15
|
| Rate for Payer: PACE SWMI |
$40.16
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Medicare |
$40.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.81
|
| Rate for Payer: Railroad Medicare Medicare |
$40.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: UHC Exchange |
$40.16
|
| Rate for Payer: UHC Medicaid |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$40.16
|
| Rate for Payer: UHCCP Medicaid |
$28.32
|
| Rate for Payer: VA VA |
$40.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.44 |
| Max. Negotiated Rate |
$433.75 |
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: BCBS Trust/PPO |
$398.04
|
| Rate for Payer: BCN Commercial |
$398.04
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$433.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.46
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$419.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.12
|
| Rate for Payer: UHC Core |
$402.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.97 |
| Max. Negotiated Rate |
$433.75 |
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: Aetna Medicare |
$125.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.61
|
| Rate for Payer: BCBS Complete |
$89.21
|
| Rate for Payer: BCBS MAPPO |
$120.49
|
| Rate for Payer: BCBS Trust/PPO |
$396.21
|
| Rate for Payer: BCN Commercial |
$396.21
|
| Rate for Payer: BCN Medicare Advantage |
$120.49
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.49
|
| Rate for Payer: Healthscope Commercial |
$433.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Mclaren Medicaid |
$84.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.51
|
| Rate for Payer: Meridian Medicaid |
$89.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.46
|
| Rate for Payer: PACE Senior Care Partners |
$114.46
|
| Rate for Payer: PACE SWMI |
$120.49
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: PHP Medicare Advantage |
$120.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$419.30
|
| Rate for Payer: Priority Health Medicare |
$121.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.44
|
| Rate for Payer: Railroad Medicare Medicare |
$120.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.12
|
| Rate for Payer: UHC Core |
$402.43
|
| Rate for Payer: UHC Exchange |
$120.49
|
| Rate for Payer: UHC Medicaid |
$84.97
|
| Rate for Payer: UHC Medicare Advantage |
$120.49
|
| Rate for Payer: UHCCP Medicaid |
$84.97
|
| Rate for Payer: VA VA |
$120.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,647.37 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,954.83
|
| Rate for Payer: BCN Commercial |
$1,954.83
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,775.18
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,059.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,082.88
|
| Rate for Payer: UHC Core |
$1,976.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$417.29 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: Aetna Medicare |
$615.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$739.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$739.66
|
| Rate for Payer: BCBS Complete |
$438.12
|
| Rate for Payer: BCBS MAPPO |
$591.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,945.84
|
| Rate for Payer: BCN Commercial |
$1,945.84
|
| Rate for Payer: BCN Medicare Advantage |
$591.73
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.73
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Mclaren Medicaid |
$417.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.31
|
| Rate for Payer: Meridian Medicaid |
$438.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$680.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$650.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,775.18
|
| Rate for Payer: PACE Senior Care Partners |
$562.14
|
| Rate for Payer: PACE SWMI |
$591.73
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: PHP Medicare Advantage |
$591.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,059.21
|
| Rate for Payer: Priority Health Medicare |
$597.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.37
|
| Rate for Payer: Railroad Medicare Medicare |
$591.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,082.88
|
| Rate for Payer: UHC Core |
$1,976.37
|
| Rate for Payer: UHC Exchange |
$591.73
|
| Rate for Payer: UHC Medicaid |
$417.29
|
| Rate for Payer: UHC Medicare Advantage |
$591.73
|
| Rate for Payer: UHCCP Medicaid |
$417.29
|
| Rate for Payer: VA VA |
$591.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$18,123.76
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,614.14 |
| Max. Negotiated Rate |
$16,311.38 |
| Rate for Payer: Aetna Commercial |
$15,405.20
|
| Rate for Payer: BCBS Trust/PPO |
$14,968.41
|
| Rate for Payer: BCN Commercial |
$14,968.41
|
| Rate for Payer: Cash Price |
$14,499.01
|
| Rate for Payer: Cofinity Commercial |
$15,586.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,499.01
|
| Rate for Payer: Healthscope Commercial |
$16,311.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,592.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,405.20
|
| Rate for Payer: Nomi Health Commercial |
$14,861.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,592.82
|
| Rate for Payer: PHP Commercial |
$15,405.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,767.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,614.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,948.91
|
| Rate for Payer: UHC Core |
$15,133.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,592.82
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$18,123.76
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,195.22 |
| Max. Negotiated Rate |
$16,311.38 |
| Rate for Payer: Aetna Commercial |
$15,405.20
|
| Rate for Payer: Aetna Medicare |
$4,712.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,663.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,663.68
|
| Rate for Payer: BCBS Complete |
$3,354.71
|
| Rate for Payer: BCBS MAPPO |
$4,530.94
|
| Rate for Payer: BCBS Trust/PPO |
$14,899.54
|
| Rate for Payer: BCN Commercial |
$14,899.54
|
| Rate for Payer: BCN Medicare Advantage |
$4,530.94
|
| Rate for Payer: Cash Price |
$14,499.01
|
| Rate for Payer: Cofinity Commercial |
$15,586.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,499.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,530.94
|
| Rate for Payer: Healthscope Commercial |
$16,311.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,592.82
|
| Rate for Payer: Mclaren Medicaid |
$3,195.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,757.49
|
| Rate for Payer: Meridian Medicaid |
$3,354.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,210.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,984.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,405.20
|
| Rate for Payer: Nomi Health Commercial |
$14,861.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,592.82
|
| Rate for Payer: PACE Senior Care Partners |
$4,304.39
|
| Rate for Payer: PACE SWMI |
$4,530.94
|
| Rate for Payer: PHP Commercial |
$15,405.20
|
| Rate for Payer: PHP Medicare Advantage |
$4,530.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,195.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,767.67
|
| Rate for Payer: Priority Health Medicare |
$4,576.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,614.14
|
| Rate for Payer: Railroad Medicare Medicare |
$4,530.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,948.91
|
| Rate for Payer: UHC Core |
$15,133.34
|
| Rate for Payer: UHC Exchange |
$4,530.94
|
| Rate for Payer: UHC Medicaid |
$3,195.22
|
| Rate for Payer: UHC Medicare Advantage |
$4,530.94
|
| Rate for Payer: UHCCP Medicaid |
$3,195.22
|
| Rate for Payer: VA VA |
$4,530.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,592.82
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,359.41
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,730.15 |
| Max. Negotiated Rate |
$4,823.47 |
| Rate for Payer: Aetna Commercial |
$4,555.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,426.34
|
| Rate for Payer: BCN Commercial |
$4,426.34
|
| Rate for Payer: Cash Price |
$4,287.53
|
| Rate for Payer: Cofinity Commercial |
$4,609.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,287.53
|
| Rate for Payer: Healthscope Commercial |
$4,823.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,019.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,555.50
|
| Rate for Payer: Nomi Health Commercial |
$4,394.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,019.56
|
| Rate for Payer: PHP Commercial |
$4,555.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,662.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,730.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,716.28
|
| Rate for Payer: UHC Core |
$4,475.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,019.56
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,359.41
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$944.86 |
| Max. Negotiated Rate |
$4,823.47 |
| Rate for Payer: Aetna Commercial |
$4,555.50
|
| Rate for Payer: Aetna Medicare |
$1,393.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,674.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,674.82
|
| Rate for Payer: BCBS Complete |
$992.03
|
| Rate for Payer: BCBS MAPPO |
$1,339.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,405.97
|
| Rate for Payer: BCN Commercial |
$4,405.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,339.85
|
| Rate for Payer: Cash Price |
$4,287.53
|
| Rate for Payer: Cofinity Commercial |
$4,609.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,287.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,339.85
|
| Rate for Payer: Healthscope Commercial |
$4,823.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,019.56
|
| Rate for Payer: Mclaren Medicaid |
$944.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,406.85
|
| Rate for Payer: Meridian Medicaid |
$992.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,540.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,473.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,555.50
|
| Rate for Payer: Nomi Health Commercial |
$4,394.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,019.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,272.86
|
| Rate for Payer: PACE SWMI |
$1,339.85
|
| Rate for Payer: PHP Commercial |
$4,555.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,339.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,662.69
|
| Rate for Payer: Priority Health Medicare |
$1,353.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,730.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,339.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,716.28
|
| Rate for Payer: UHC Core |
$4,475.11
|
| Rate for Payer: UHC Exchange |
$1,339.85
|
| Rate for Payer: UHC Medicaid |
$944.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.85
|
| Rate for Payer: UHCCP Medicaid |
$944.86
|
| Rate for Payer: VA VA |
$1,339.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,019.56
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$437.34
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.39 |
| Max. Negotiated Rate |
$393.61 |
| Rate for Payer: Aetna Commercial |
$371.74
|
| Rate for Payer: BCBS Trust/PPO |
$361.20
|
| Rate for Payer: BCN Commercial |
$361.20
|
| Rate for Payer: Cash Price |
$349.87
|
| Rate for Payer: Cofinity Commercial |
$376.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.87
|
| Rate for Payer: Healthscope Commercial |
$393.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.74
|
| Rate for Payer: Nomi Health Commercial |
$358.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.00
|
| Rate for Payer: PHP Commercial |
$371.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.86
|
| Rate for Payer: UHC Core |
$365.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.00
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$437.34
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.10 |
| Max. Negotiated Rate |
$393.61 |
| Rate for Payer: Aetna Commercial |
$371.74
|
| Rate for Payer: Aetna Medicare |
$113.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.67
|
| Rate for Payer: BCBS Complete |
$80.95
|
| Rate for Payer: BCBS MAPPO |
$109.33
|
| Rate for Payer: BCBS Trust/PPO |
$359.54
|
| Rate for Payer: BCN Commercial |
$359.54
|
| Rate for Payer: BCN Medicare Advantage |
$109.33
|
| Rate for Payer: Cash Price |
$349.87
|
| Rate for Payer: Cofinity Commercial |
$376.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.33
|
| Rate for Payer: Healthscope Commercial |
$393.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.00
|
| Rate for Payer: Mclaren Medicaid |
$77.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.80
|
| Rate for Payer: Meridian Medicaid |
$80.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.74
|
| Rate for Payer: Nomi Health Commercial |
$358.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.00
|
| Rate for Payer: PACE Senior Care Partners |
$103.87
|
| Rate for Payer: PACE SWMI |
$109.33
|
| Rate for Payer: PHP Commercial |
$371.74
|
| Rate for Payer: PHP Medicare Advantage |
$109.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.49
|
| Rate for Payer: Priority Health Medicare |
$110.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.39
|
| Rate for Payer: Railroad Medicare Medicare |
$109.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.86
|
| Rate for Payer: UHC Core |
$365.18
|
| Rate for Payer: UHC Exchange |
$109.33
|
| Rate for Payer: UHC Medicaid |
$77.10
|
| Rate for Payer: UHC Medicare Advantage |
$109.33
|
| Rate for Payer: UHCCP Medicaid |
$77.10
|
| Rate for Payer: VA VA |
$109.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.00
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$22,634.58
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,990.48 |
| Max. Negotiated Rate |
$20,371.12 |
| Rate for Payer: Aetna Commercial |
$19,239.39
|
| Rate for Payer: Aetna Medicare |
$5,884.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,073.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,073.31
|
| Rate for Payer: BCBS Complete |
$4,189.66
|
| Rate for Payer: BCBS MAPPO |
$5,658.65
|
| Rate for Payer: BCBS Trust/PPO |
$18,607.89
|
| Rate for Payer: BCN Commercial |
$18,607.89
|
| Rate for Payer: BCN Medicare Advantage |
$5,658.65
|
| Rate for Payer: Cash Price |
$18,107.66
|
| Rate for Payer: Cofinity Commercial |
$19,465.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,107.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,658.65
|
| Rate for Payer: Healthscope Commercial |
$20,371.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,975.94
|
| Rate for Payer: Mclaren Medicaid |
$3,990.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,941.58
|
| Rate for Payer: Meridian Medicaid |
$4,189.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,507.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,224.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,239.39
|
| Rate for Payer: Nomi Health Commercial |
$18,560.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,975.94
|
| Rate for Payer: PACE Senior Care Partners |
$5,375.71
|
| Rate for Payer: PACE SWMI |
$5,658.65
|
| Rate for Payer: PHP Commercial |
$19,239.39
|
| Rate for Payer: PHP Medicare Advantage |
$5,658.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,990.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,692.08
|
| Rate for Payer: Priority Health Medicare |
$5,715.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,753.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5,658.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,918.43
|
| Rate for Payer: UHC Core |
$18,899.87
|
| Rate for Payer: UHC Exchange |
$5,658.65
|
| Rate for Payer: UHC Medicaid |
$3,990.48
|
| Rate for Payer: UHC Medicare Advantage |
$5,658.65
|
| Rate for Payer: UHCCP Medicaid |
$3,990.48
|
| Rate for Payer: VA VA |
$5,658.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,975.94
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$22,634.58
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,753.67 |
| Max. Negotiated Rate |
$20,371.12 |
| Rate for Payer: Aetna Commercial |
$19,239.39
|
| Rate for Payer: BCBS Trust/PPO |
$18,693.90
|
| Rate for Payer: BCN Commercial |
$18,693.90
|
| Rate for Payer: Cash Price |
$18,107.66
|
| Rate for Payer: Cofinity Commercial |
$19,465.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18,107.66
|
| Rate for Payer: Healthscope Commercial |
$20,371.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,975.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,239.39
|
| Rate for Payer: Nomi Health Commercial |
$18,560.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,975.94
|
| Rate for Payer: PHP Commercial |
$19,239.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,692.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,753.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,918.43
|
| Rate for Payer: UHC Core |
$18,899.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,975.94
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$6,020.46
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,190.24 |
| Max. Negotiated Rate |
$5,418.41 |
| Rate for Payer: Aetna Commercial |
$5,117.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,972.30
|
| Rate for Payer: BCN Commercial |
$4,972.30
|
| Rate for Payer: Cash Price |
$4,816.37
|
| Rate for Payer: Cofinity Commercial |
$5,177.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,816.37
|
| Rate for Payer: Healthscope Commercial |
$5,418.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,515.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,117.39
|
| Rate for Payer: Nomi Health Commercial |
$4,936.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,515.35
|
| Rate for Payer: PHP Commercial |
$5,117.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,237.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,190.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,298.00
|
| Rate for Payer: UHC Core |
$5,027.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,515.35
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$6,020.46
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.41 |
| Max. Negotiated Rate |
$5,418.41 |
| Rate for Payer: Aetna Commercial |
$5,117.39
|
| Rate for Payer: Aetna Medicare |
$1,565.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,881.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,881.39
|
| Rate for Payer: BCBS Complete |
$1,114.39
|
| Rate for Payer: BCBS MAPPO |
$1,505.12
|
| Rate for Payer: BCBS Trust/PPO |
$4,949.42
|
| Rate for Payer: BCN Commercial |
$4,949.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,505.12
|
| Rate for Payer: Cash Price |
$4,816.37
|
| Rate for Payer: Cofinity Commercial |
$5,177.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,816.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,505.12
|
| Rate for Payer: Healthscope Commercial |
$5,418.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,515.35
|
| Rate for Payer: Mclaren Medicaid |
$1,061.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,580.37
|
| Rate for Payer: Meridian Medicaid |
$1,114.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,730.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,655.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,117.39
|
| Rate for Payer: Nomi Health Commercial |
$4,936.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,515.35
|
| Rate for Payer: PACE Senior Care Partners |
$1,429.86
|
| Rate for Payer: PACE SWMI |
$1,505.12
|
| Rate for Payer: PHP Commercial |
$5,117.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,505.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,061.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,237.80
|
| Rate for Payer: Priority Health Medicare |
$1,520.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,190.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,505.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,298.00
|
| Rate for Payer: UHC Core |
$5,027.08
|
| Rate for Payer: UHC Exchange |
$1,505.12
|
| Rate for Payer: UHC Medicaid |
$1,061.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,505.12
|
| Rate for Payer: UHCCP Medicaid |
$1,061.41
|
| Rate for Payer: VA VA |
$1,505.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,515.35
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$358.06
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$249.21 |
| Max. Negotiated Rate |
$322.25 |
| Rate for Payer: Aetna Commercial |
$304.35
|
| Rate for Payer: BCBS Trust/PPO |
$295.72
|
| Rate for Payer: BCN Commercial |
$295.72
|
| Rate for Payer: Cash Price |
$286.45
|
| Rate for Payer: Cofinity Commercial |
$307.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.45
|
| Rate for Payer: Healthscope Commercial |
$322.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.35
|
| Rate for Payer: Nomi Health Commercial |
$293.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.55
|
| Rate for Payer: PHP Commercial |
$304.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.09
|
| Rate for Payer: UHC Core |
$298.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.55
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$358.06
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$63.13 |
| Max. Negotiated Rate |
$322.25 |
| Rate for Payer: Aetna Commercial |
$304.35
|
| Rate for Payer: Aetna Medicare |
$93.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.89
|
| Rate for Payer: BCBS Complete |
$66.28
|
| Rate for Payer: BCBS MAPPO |
$89.52
|
| Rate for Payer: BCBS Trust/PPO |
$294.36
|
| Rate for Payer: BCN Commercial |
$294.36
|
| Rate for Payer: BCN Medicare Advantage |
$89.52
|
| Rate for Payer: Cash Price |
$286.45
|
| Rate for Payer: Cofinity Commercial |
$307.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.52
|
| Rate for Payer: Healthscope Commercial |
$322.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.55
|
| Rate for Payer: Mclaren Medicaid |
$63.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.99
|
| Rate for Payer: Meridian Medicaid |
$66.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.35
|
| Rate for Payer: Nomi Health Commercial |
$293.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.55
|
| Rate for Payer: PACE Senior Care Partners |
$85.04
|
| Rate for Payer: PACE SWMI |
$89.52
|
| Rate for Payer: PHP Commercial |
$304.35
|
| Rate for Payer: PHP Medicare Advantage |
$89.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.51
|
| Rate for Payer: Priority Health Medicare |
$90.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.21
|
| Rate for Payer: Railroad Medicare Medicare |
$89.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.09
|
| Rate for Payer: UHC Core |
$298.98
|
| Rate for Payer: UHC Exchange |
$89.52
|
| Rate for Payer: UHC Medicaid |
$63.13
|
| Rate for Payer: UHC Medicare Advantage |
$89.52
|
| Rate for Payer: UHCCP Medicaid |
$63.13
|
| Rate for Payer: VA VA |
$89.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.55
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$372.42
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$65.66 |
| Max. Negotiated Rate |
$335.18 |
| Rate for Payer: Aetna Commercial |
$316.56
|
| Rate for Payer: Aetna Medicare |
$96.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.38
|
| Rate for Payer: BCBS Complete |
$68.93
|
| Rate for Payer: BCBS MAPPO |
$93.11
|
| Rate for Payer: BCBS Trust/PPO |
$306.17
|
| Rate for Payer: BCN Commercial |
$306.17
|
| Rate for Payer: BCN Medicare Advantage |
$93.11
|
| Rate for Payer: Cash Price |
$297.94
|
| Rate for Payer: Cofinity Commercial |
$320.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.11
|
| Rate for Payer: Healthscope Commercial |
$335.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.31
|
| Rate for Payer: Mclaren Medicaid |
$65.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.76
|
| Rate for Payer: Meridian Medicaid |
$68.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.56
|
| Rate for Payer: Nomi Health Commercial |
$305.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.31
|
| Rate for Payer: PACE Senior Care Partners |
$88.45
|
| Rate for Payer: PACE SWMI |
$93.11
|
| Rate for Payer: PHP Commercial |
$316.56
|
| Rate for Payer: PHP Medicare Advantage |
$93.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.01
|
| Rate for Payer: Priority Health Medicare |
$94.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.20
|
| Rate for Payer: Railroad Medicare Medicare |
$93.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.73
|
| Rate for Payer: UHC Core |
$310.97
|
| Rate for Payer: UHC Exchange |
$93.11
|
| Rate for Payer: UHC Medicaid |
$65.66
|
| Rate for Payer: UHC Medicare Advantage |
$93.11
|
| Rate for Payer: UHCCP Medicaid |
$65.66
|
| Rate for Payer: VA VA |
$93.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.31
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$372.42
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$259.20 |
| Max. Negotiated Rate |
$335.18 |
| Rate for Payer: Aetna Commercial |
$316.56
|
| Rate for Payer: BCBS Trust/PPO |
$307.58
|
| Rate for Payer: BCN Commercial |
$307.58
|
| Rate for Payer: Cash Price |
$297.94
|
| Rate for Payer: Cofinity Commercial |
$320.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.94
|
| Rate for Payer: Healthscope Commercial |
$335.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.56
|
| Rate for Payer: Nomi Health Commercial |
$305.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.31
|
| Rate for Payer: PHP Commercial |
$316.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.73
|
| Rate for Payer: UHC Core |
$310.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.31
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$251.30
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$226.17 |
| Rate for Payer: Aetna Commercial |
$213.60
|
| Rate for Payer: Aetna Medicare |
$65.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.53
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$62.83
|
| Rate for Payer: BCBS Trust/PPO |
$206.59
|
| Rate for Payer: BCN Commercial |
$206.59
|
| Rate for Payer: BCN Medicare Advantage |
$62.83
|
| Rate for Payer: Cash Price |
$201.04
|
| Rate for Payer: Cofinity Commercial |
$216.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.83
|
| Rate for Payer: Healthscope Commercial |
$226.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.47
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.97
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.60
|
| Rate for Payer: Nomi Health Commercial |
$206.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.47
|
| Rate for Payer: PACE Senior Care Partners |
$59.68
|
| Rate for Payer: PACE SWMI |
$62.83
|
| Rate for Payer: PHP Commercial |
$213.60
|
| Rate for Payer: PHP Medicare Advantage |
$62.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$218.63
|
| Rate for Payer: Priority Health Medicare |
$63.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.90
|
| Rate for Payer: Railroad Medicare Medicare |
$62.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.14
|
| Rate for Payer: UHC Core |
$209.84
|
| Rate for Payer: UHC Exchange |
$62.83
|
| Rate for Payer: UHC Medicaid |
$44.30
|
| Rate for Payer: UHC Medicare Advantage |
$62.83
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
| Rate for Payer: VA VA |
$62.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.47
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$251.30
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$174.90 |
| Max. Negotiated Rate |
$226.17 |
| Rate for Payer: Aetna Commercial |
$213.60
|
| Rate for Payer: BCBS Trust/PPO |
$207.55
|
| Rate for Payer: BCN Commercial |
$207.55
|
| Rate for Payer: Cash Price |
$201.04
|
| Rate for Payer: Cofinity Commercial |
$216.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.04
|
| Rate for Payer: Healthscope Commercial |
$226.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.60
|
| Rate for Payer: Nomi Health Commercial |
$206.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.47
|
| Rate for Payer: PHP Commercial |
$213.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$218.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.14
|
| Rate for Payer: UHC Core |
$209.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.47
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$624.29
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$434.51 |
| Max. Negotiated Rate |
$561.86 |
| Rate for Payer: Aetna Commercial |
$530.65
|
| Rate for Payer: BCBS Trust/PPO |
$515.60
|
| Rate for Payer: BCN Commercial |
$515.60
|
| Rate for Payer: Cash Price |
$499.43
|
| Rate for Payer: Cofinity Commercial |
$536.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.43
|
| Rate for Payer: Healthscope Commercial |
$561.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.65
|
| Rate for Payer: Nomi Health Commercial |
$511.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.22
|
| Rate for Payer: PHP Commercial |
$530.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.38
|
| Rate for Payer: UHC Core |
$521.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.22
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$624.29
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$110.06 |
| Max. Negotiated Rate |
$561.86 |
| Rate for Payer: Aetna Commercial |
$530.65
|
| Rate for Payer: Aetna Medicare |
$162.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.09
|
| Rate for Payer: BCBS Complete |
$115.56
|
| Rate for Payer: BCBS MAPPO |
$156.07
|
| Rate for Payer: BCBS Trust/PPO |
$513.23
|
| Rate for Payer: BCN Commercial |
$513.23
|
| Rate for Payer: BCN Medicare Advantage |
$156.07
|
| Rate for Payer: Cash Price |
$499.43
|
| Rate for Payer: Cofinity Commercial |
$536.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.07
|
| Rate for Payer: Healthscope Commercial |
$561.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.22
|
| Rate for Payer: Mclaren Medicaid |
$110.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.88
|
| Rate for Payer: Meridian Medicaid |
$115.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.65
|
| Rate for Payer: Nomi Health Commercial |
$511.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.22
|
| Rate for Payer: PACE Senior Care Partners |
$148.27
|
| Rate for Payer: PACE SWMI |
$156.07
|
| Rate for Payer: PHP Commercial |
$530.65
|
| Rate for Payer: PHP Medicare Advantage |
$156.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.13
|
| Rate for Payer: Priority Health Medicare |
$157.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.51
|
| Rate for Payer: Railroad Medicare Medicare |
$156.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.38
|
| Rate for Payer: UHC Core |
$521.28
|
| Rate for Payer: UHC Exchange |
$156.07
|
| Rate for Payer: UHC Medicaid |
$110.06
|
| Rate for Payer: UHC Medicare Advantage |
$156.07
|
| Rate for Payer: UHCCP Medicaid |
$110.06
|
| Rate for Payer: VA VA |
$156.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.22
|
|
