|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,391.73 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,003.64
|
| Rate for Payer: BCN Commercial |
$2,843.58
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: Nomi Health Commercial |
$3,017.26
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health HMO/PPO |
$3,201.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,465.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,238.03
|
| Rate for Payer: UHC Core |
$3,072.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.68
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.19 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$8.78
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$16.99
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Mclaren Medicaid |
$8.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: Meridian Medicaid |
$8.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHCCP Medicaid |
$8.37
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: BCN Commercial |
$16.89
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.20
|
| Rate for Payer: Priority Health HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,308.69
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$4,750.65 |
| Max. Negotiated Rate |
$6,577.82 |
| Rate for Payer: Aetna Commercial |
$6,212.39
|
| Rate for Payer: BCBS Trust/PPO |
$5,966.08
|
| Rate for Payer: BCN Commercial |
$5,648.16
|
| Rate for Payer: Cash Price |
$5,846.95
|
| Rate for Payer: Cofinity Commercial |
$6,285.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,846.95
|
| Rate for Payer: Healthscope Commercial |
$6,577.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,481.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,212.39
|
| Rate for Payer: Nomi Health Commercial |
$5,993.13
|
| Rate for Payer: PHP Commercial |
$6,212.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,750.65
|
| Rate for Payer: Priority Health HMO/PPO |
$6,358.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,896.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,431.65
|
| Rate for Payer: UHC Core |
$6,102.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,481.52
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: Aetna Medicare |
$964.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,159.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,159.26
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$927.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,049.70
|
| Rate for Payer: BCN Commercial |
$2,884.25
|
| Rate for Payer: BCN Medicare Advantage |
$927.41
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$927.41
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,782.23
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$973.78
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,066.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: Nomi Health Commercial |
$3,041.90
|
| Rate for Payer: PACE Senior Care Partners |
$881.04
|
| Rate for Payer: PACE SWMI |
$927.41
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: PHP Medicare Advantage |
$927.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,227.39
|
| Rate for Payer: Priority Health Medicare |
$936.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,485.46
|
| Rate for Payer: Railroad Medicare Medicare |
$927.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,264.48
|
| Rate for Payer: UHC Core |
$3,097.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$927.41
|
| Rate for Payer: UHC Exchange |
$927.41
|
| Rate for Payer: UHC Medicare Advantage |
$927.41
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$927.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,782.23
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,709.64
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,411.27 |
| Max. Negotiated Rate |
$3,338.68 |
| Rate for Payer: Aetna Commercial |
$3,153.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,028.18
|
| Rate for Payer: BCN Commercial |
$2,866.81
|
| Rate for Payer: Cash Price |
$2,967.71
|
| Rate for Payer: Cofinity Commercial |
$3,190.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,967.71
|
| Rate for Payer: Healthscope Commercial |
$3,338.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,782.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,153.19
|
| Rate for Payer: Nomi Health Commercial |
$3,041.90
|
| Rate for Payer: PHP Commercial |
$3,153.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,411.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,227.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,485.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,264.48
|
| Rate for Payer: UHC Core |
$3,097.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,782.23
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: Aetna Medicare |
$650.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.96
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$625.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.11
|
| Rate for Payer: BCN Commercial |
$1,945.51
|
| Rate for Payer: BCN Medicare Advantage |
$625.57
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.57
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.69
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.84
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: Nomi Health Commercial |
$2,051.85
|
| Rate for Payer: PACE Senior Care Partners |
$594.29
|
| Rate for Payer: PACE SWMI |
$625.57
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: PHP Medicare Advantage |
$625.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,176.97
|
| Rate for Payer: Priority Health Medicare |
$631.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,676.51
|
| Rate for Payer: Railroad Medicare Medicare |
$625.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.99
|
| Rate for Payer: UHC Core |
$2,089.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.57
|
| Rate for Payer: UHC Exchange |
$625.57
|
| Rate for Payer: UHC Medicare Advantage |
$625.57
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$625.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.69
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,502.26
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,626.47 |
| Max. Negotiated Rate |
$2,252.03 |
| Rate for Payer: Aetna Commercial |
$2,126.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,042.59
|
| Rate for Payer: BCN Commercial |
$1,933.75
|
| Rate for Payer: Cash Price |
$2,001.81
|
| Rate for Payer: Cofinity Commercial |
$2,151.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.81
|
| Rate for Payer: Healthscope Commercial |
$2,252.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,126.92
|
| Rate for Payer: Nomi Health Commercial |
$2,051.85
|
| Rate for Payer: PHP Commercial |
$2,126.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,626.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,176.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,676.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.99
|
| Rate for Payer: UHC Core |
$2,089.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.69
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,881.86 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,619.17
|
| Rate for Payer: BCN Commercial |
$3,426.31
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: Nomi Health Commercial |
$3,635.58
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health HMO/PPO |
$3,857.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,901.59
|
| Rate for Payer: UHC Core |
$3,702.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.22
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,433.63
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$3,990.27 |
| Rate for Payer: Aetna Commercial |
$3,768.59
|
| Rate for Payer: Aetna Medicare |
$1,152.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,385.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,385.51
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$1,108.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,644.89
|
| Rate for Payer: BCN Commercial |
$3,447.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,108.41
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cash Price |
$3,546.90
|
| Rate for Payer: Cofinity Commercial |
$3,812.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,108.41
|
| Rate for Payer: Healthscope Commercial |
$3,990.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.22
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,163.83
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,274.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.59
|
| Rate for Payer: Nomi Health Commercial |
$3,635.58
|
| Rate for Payer: PACE Senior Care Partners |
$1,052.99
|
| Rate for Payer: PACE SWMI |
$1,108.41
|
| Rate for Payer: PHP Commercial |
$3,768.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,108.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,881.86
|
| Rate for Payer: Priority Health HMO/PPO |
$3,857.26
|
| Rate for Payer: Priority Health Medicare |
$1,119.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,108.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,901.59
|
| Rate for Payer: UHC Core |
$3,702.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,108.41
|
| Rate for Payer: UHC Exchange |
$1,108.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,108.41
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$1,108.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.22
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna Medicare |
$285.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.94
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$274.36
|
| Rate for Payer: BCBS Trust/PPO |
$902.19
|
| Rate for Payer: BCN Commercial |
$853.24
|
| Rate for Payer: BCN Medicare Advantage |
$274.36
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.36
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.07
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: Nomi Health Commercial |
$899.88
|
| Rate for Payer: PACE Senior Care Partners |
$260.64
|
| Rate for Payer: PACE SWMI |
$274.36
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: PHP Medicare Advantage |
$274.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health HMO/PPO |
$954.76
|
| Rate for Payer: Priority Health Medicare |
$277.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.27
|
| Rate for Payer: Railroad Medicare Medicare |
$274.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.73
|
| Rate for Payer: UHC Core |
$916.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.36
|
| Rate for Payer: UHC Exchange |
$274.36
|
| Rate for Payer: UHC Medicare Advantage |
$274.36
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$274.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,097.42
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$713.32 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: BCBS Trust/PPO |
$895.82
|
| Rate for Payer: BCN Commercial |
$848.09
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: Nomi Health Commercial |
$899.88
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health HMO/PPO |
$954.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.73
|
| Rate for Payer: UHC Core |
$916.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,273.84 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.74
|
| Rate for Payer: BCN Commercial |
$1,514.49
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: Nomi Health Commercial |
$1,606.99
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,313.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.58
|
| Rate for Payer: UHC Core |
$1,636.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,959.75
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,763.78 |
| Rate for Payer: Aetna Commercial |
$1,665.79
|
| Rate for Payer: Aetna Medicare |
$509.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.42
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$489.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.11
|
| Rate for Payer: BCN Commercial |
$1,523.71
|
| Rate for Payer: BCN Medicare Advantage |
$489.94
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cash Price |
$1,567.80
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.94
|
| Rate for Payer: Healthscope Commercial |
$1,763.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.43
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.79
|
| Rate for Payer: Nomi Health Commercial |
$1,606.99
|
| Rate for Payer: PACE Senior Care Partners |
$465.44
|
| Rate for Payer: PACE SWMI |
$489.94
|
| Rate for Payer: PHP Commercial |
$1,665.79
|
| Rate for Payer: PHP Medicare Advantage |
$489.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.98
|
| Rate for Payer: Priority Health Medicare |
$494.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,313.03
|
| Rate for Payer: Railroad Medicare Medicare |
$489.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.58
|
| Rate for Payer: UHC Core |
$1,636.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.94
|
| Rate for Payer: UHC Exchange |
$489.94
|
| Rate for Payer: UHC Medicare Advantage |
$489.94
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$489.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna Commercial |
$1,365.87
|
| Rate for Payer: Aetna Medicare |
$417.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$502.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$502.16
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$401.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.03
|
| Rate for Payer: BCN Commercial |
$1,249.36
|
| Rate for Payer: BCN Medicare Advantage |
$401.73
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.73
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.17
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.81
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.87
|
| Rate for Payer: Nomi Health Commercial |
$1,317.66
|
| Rate for Payer: PACE Senior Care Partners |
$381.64
|
| Rate for Payer: PACE SWMI |
$401.73
|
| Rate for Payer: PHP Commercial |
$1,365.87
|
| Rate for Payer: PHP Medicare Advantage |
$401.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,398.00
|
| Rate for Payer: Priority Health Medicare |
$405.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.62
|
| Rate for Payer: Railroad Medicare Medicare |
$401.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.07
|
| Rate for Payer: UHC Core |
$1,341.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.73
|
| Rate for Payer: UHC Exchange |
$401.73
|
| Rate for Payer: UHC Medicare Advantage |
$401.73
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$401.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.17
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,606.90
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,044.48 |
| Max. Negotiated Rate |
$1,446.21 |
| Rate for Payer: Aetna Commercial |
$1,365.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.71
|
| Rate for Payer: BCN Commercial |
$1,241.81
|
| Rate for Payer: Cash Price |
$1,285.52
|
| Rate for Payer: Cofinity Commercial |
$1,381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.52
|
| Rate for Payer: Healthscope Commercial |
$1,446.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.87
|
| Rate for Payer: Nomi Health Commercial |
$1,317.66
|
| Rate for Payer: PHP Commercial |
$1,365.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,398.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,414.07
|
| Rate for Payer: UHC Core |
$1,341.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.17
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,453.63
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,594.86 |
| Max. Negotiated Rate |
$2,208.27 |
| Rate for Payer: Aetna Commercial |
$2,085.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,002.90
|
| Rate for Payer: BCN Commercial |
$1,896.17
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cofinity Commercial |
$2,110.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.90
|
| Rate for Payer: Healthscope Commercial |
$2,208.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,085.59
|
| Rate for Payer: Nomi Health Commercial |
$2,011.98
|
| Rate for Payer: PHP Commercial |
$2,085.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.86
|
| Rate for Payer: Priority Health HMO/PPO |
$2,134.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,643.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,159.19
|
| Rate for Payer: UHC Core |
$2,048.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.22
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,453.63
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$2,208.27 |
| Rate for Payer: Aetna Commercial |
$2,085.59
|
| Rate for Payer: Aetna Medicare |
$637.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$766.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$766.76
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$613.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,017.13
|
| Rate for Payer: BCN Commercial |
$1,907.70
|
| Rate for Payer: BCN Medicare Advantage |
$613.41
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cash Price |
$1,962.90
|
| Rate for Payer: Cofinity Commercial |
$2,110.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$613.41
|
| Rate for Payer: Healthscope Commercial |
$2,208.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.22
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$644.08
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$705.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,085.59
|
| Rate for Payer: Nomi Health Commercial |
$2,011.98
|
| Rate for Payer: PACE Senior Care Partners |
$582.74
|
| Rate for Payer: PACE SWMI |
$613.41
|
| Rate for Payer: PHP Commercial |
$2,085.59
|
| Rate for Payer: PHP Medicare Advantage |
$613.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,594.86
|
| Rate for Payer: Priority Health HMO/PPO |
$2,134.66
|
| Rate for Payer: Priority Health Medicare |
$619.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,643.93
|
| Rate for Payer: Railroad Medicare Medicare |
$613.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,159.19
|
| Rate for Payer: UHC Core |
$2,048.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$613.41
|
| Rate for Payer: UHC Exchange |
$613.41
|
| Rate for Payer: UHC Medicare Advantage |
$613.41
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$613.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.22
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
IP
|
$1,097.42
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$713.32 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: BCBS Trust/PPO |
$895.82
|
| Rate for Payer: BCN Commercial |
$848.09
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: Nomi Health Commercial |
$899.88
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health HMO/PPO |
$954.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.73
|
| Rate for Payer: UHC Core |
$916.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
OP
|
$1,097.42
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$260.64 |
| Max. Negotiated Rate |
$987.68 |
| Rate for Payer: Aetna Commercial |
$932.81
|
| Rate for Payer: Aetna Medicare |
$285.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.94
|
| Rate for Payer: BCBS Complete |
$438.97
|
| Rate for Payer: BCBS MAPPO |
$274.36
|
| Rate for Payer: BCBS Trust/PPO |
$902.19
|
| Rate for Payer: BCN Commercial |
$853.24
|
| Rate for Payer: BCN Medicare Advantage |
$274.36
|
| Rate for Payer: Cash Price |
$877.94
|
| Rate for Payer: Cofinity Commercial |
$943.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.36
|
| Rate for Payer: Healthscope Commercial |
$987.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.81
|
| Rate for Payer: Nomi Health Commercial |
$899.88
|
| Rate for Payer: PACE Senior Care Partners |
$260.64
|
| Rate for Payer: PACE SWMI |
$274.36
|
| Rate for Payer: PHP Commercial |
$932.81
|
| Rate for Payer: PHP Medicare Advantage |
$274.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.32
|
| Rate for Payer: Priority Health HMO/PPO |
$954.76
|
| Rate for Payer: Priority Health Medicare |
$277.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$735.27
|
| Rate for Payer: Railroad Medicare Medicare |
$274.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.73
|
| Rate for Payer: UHC Core |
$916.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.36
|
| Rate for Payer: UHC Exchange |
$274.36
|
| Rate for Payer: UHC Medicare Advantage |
$274.36
|
| Rate for Payer: VA VA |
$274.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.07
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
IP
|
$3,085.62
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$2,005.65 |
| Max. Negotiated Rate |
$2,777.06 |
| Rate for Payer: Aetna Commercial |
$2,622.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,518.79
|
| Rate for Payer: BCN Commercial |
$2,384.57
|
| Rate for Payer: Cash Price |
$2,468.50
|
| Rate for Payer: Cofinity Commercial |
$2,653.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,468.50
|
| Rate for Payer: Healthscope Commercial |
$2,777.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,314.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,622.78
|
| Rate for Payer: Nomi Health Commercial |
$2,530.21
|
| Rate for Payer: PHP Commercial |
$2,622.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,005.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,684.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,715.35
|
| Rate for Payer: UHC Core |
$2,576.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,314.22
|
|
|
HC CT ANGIO ABD AND PELVIS
|
Facility
|
OP
|
$3,085.62
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
35000034
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,777.06 |
| Rate for Payer: Aetna Commercial |
$2,622.78
|
| Rate for Payer: Aetna Medicare |
$802.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$964.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$964.26
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$771.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,536.69
|
| Rate for Payer: BCN Commercial |
$2,399.07
|
| Rate for Payer: BCN Medicare Advantage |
$771.40
|
| Rate for Payer: Cash Price |
$2,468.50
|
| Rate for Payer: Cash Price |
$2,468.50
|
| Rate for Payer: Cofinity Commercial |
$2,653.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,468.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.40
|
| Rate for Payer: Healthscope Commercial |
$2,777.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,314.22
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.98
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$887.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,622.78
|
| Rate for Payer: Nomi Health Commercial |
$2,530.21
|
| Rate for Payer: PACE Senior Care Partners |
$732.83
|
| Rate for Payer: PACE SWMI |
$771.40
|
| Rate for Payer: PHP Commercial |
$2,622.78
|
| Rate for Payer: PHP Medicare Advantage |
$771.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,005.65
|
| Rate for Payer: Priority Health HMO/PPO |
$2,684.49
|
| Rate for Payer: Priority Health Medicare |
$779.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.37
|
| Rate for Payer: Railroad Medicare Medicare |
$771.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,715.35
|
| Rate for Payer: UHC Core |
$2,576.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.40
|
| Rate for Payer: UHC Exchange |
$771.40
|
| Rate for Payer: UHC Medicare Advantage |
$771.40
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$771.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,314.22
|
|
|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
IP
|
$1,316.94
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$856.01 |
| Max. Negotiated Rate |
$1,185.25 |
| Rate for Payer: Aetna Commercial |
$1,119.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.02
|
| Rate for Payer: BCN Commercial |
$1,017.73
|
| Rate for Payer: Cash Price |
$1,053.55
|
| Rate for Payer: Cofinity Commercial |
$1,132.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,053.55
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,119.40
|
| Rate for Payer: Nomi Health Commercial |
$1,079.89
|
| Rate for Payer: PHP Commercial |
$1,119.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,145.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$882.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.91
|
| Rate for Payer: UHC Core |
$1,099.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.71
|
|
