|
HC CT ANGIO CORONARY DISCONTINUED
|
Facility
|
OP
|
$1,316.94
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000018
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$1,185.25 |
| Rate for Payer: Aetna Commercial |
$1,119.40
|
| Rate for Payer: Aetna Medicare |
$342.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.54
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$329.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,082.66
|
| Rate for Payer: BCN Commercial |
$1,023.92
|
| Rate for Payer: BCN Medicare Advantage |
$329.24
|
| Rate for Payer: Cash Price |
$1,053.55
|
| 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: Health Alliance Plan Medicare Advantage |
$329.24
|
| Rate for Payer: Healthscope Commercial |
$1,185.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.71
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.70
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,119.40
|
| Rate for Payer: Nomi Health Commercial |
$1,079.89
|
| Rate for Payer: PACE Senior Care Partners |
$312.77
|
| Rate for Payer: PACE SWMI |
$329.24
|
| Rate for Payer: PHP Commercial |
$1,119.40
|
| Rate for Payer: PHP Medicare Advantage |
$329.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| 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 Medicare |
$332.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$882.35
|
| Rate for Payer: Railroad Medicare Medicare |
$329.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.91
|
| Rate for Payer: UHC Core |
$1,099.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.24
|
| Rate for Payer: UHC Exchange |
$329.24
|
| Rate for Payer: UHC Medicare Advantage |
$329.24
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$329.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.71
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
OP
|
$2,156.43
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,940.79 |
| Rate for Payer: Aetna Commercial |
$1,832.97
|
| Rate for Payer: Aetna Medicare |
$560.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$673.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$673.88
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$539.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,772.80
|
| Rate for Payer: BCN Commercial |
$1,676.62
|
| Rate for Payer: BCN Medicare Advantage |
$539.11
|
| Rate for Payer: Cash Price |
$1,725.14
|
| Rate for Payer: Cash Price |
$1,725.14
|
| Rate for Payer: Cofinity Commercial |
$1,854.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.11
|
| Rate for Payer: Healthscope Commercial |
$1,940.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.32
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.06
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$619.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,832.97
|
| Rate for Payer: Nomi Health Commercial |
$1,768.27
|
| Rate for Payer: PACE Senior Care Partners |
$512.15
|
| Rate for Payer: PACE SWMI |
$539.11
|
| Rate for Payer: PHP Commercial |
$1,832.97
|
| Rate for Payer: PHP Medicare Advantage |
$539.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,876.09
|
| Rate for Payer: Priority Health Medicare |
$544.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.81
|
| Rate for Payer: Railroad Medicare Medicare |
$539.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,897.66
|
| Rate for Payer: UHC Core |
$1,800.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.11
|
| Rate for Payer: UHC Exchange |
$539.11
|
| Rate for Payer: UHC Medicare Advantage |
$539.11
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$539.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.32
|
|
|
HC CT AORTA W RUNOFF ANGIO
|
Facility
|
IP
|
$2,156.43
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
35000020
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,401.68 |
| Max. Negotiated Rate |
$1,940.79 |
| Rate for Payer: Aetna Commercial |
$1,832.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,760.29
|
| Rate for Payer: BCN Commercial |
$1,666.49
|
| Rate for Payer: Cash Price |
$1,725.14
|
| Rate for Payer: Cofinity Commercial |
$1,854.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.14
|
| Rate for Payer: Healthscope Commercial |
$1,940.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,832.97
|
| Rate for Payer: Nomi Health Commercial |
$1,768.27
|
| Rate for Payer: PHP Commercial |
$1,832.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,401.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,876.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,897.66
|
| Rate for Payer: UHC Core |
$1,800.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.32
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
IP
|
$691.71
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$449.61 |
| Max. Negotiated Rate |
$622.54 |
| Rate for Payer: Aetna Commercial |
$587.95
|
| Rate for Payer: BCBS Trust/PPO |
$564.64
|
| Rate for Payer: BCN Commercial |
$534.55
|
| Rate for Payer: Cash Price |
$553.37
|
| Rate for Payer: Cofinity Commercial |
$594.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.37
|
| Rate for Payer: Healthscope Commercial |
$622.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.95
|
| Rate for Payer: Nomi Health Commercial |
$567.20
|
| Rate for Payer: PHP Commercial |
$587.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.61
|
| Rate for Payer: Priority Health HMO/PPO |
$601.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.70
|
| Rate for Payer: UHC Core |
$577.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.78
|
|
|
HC CT BONE LENGTH STUDY
|
Facility
|
OP
|
$691.71
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
32000255
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$622.54 |
| Rate for Payer: Aetna Commercial |
$587.95
|
| Rate for Payer: Aetna Medicare |
$179.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$216.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$216.16
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$172.93
|
| Rate for Payer: BCBS Trust/PPO |
$568.65
|
| Rate for Payer: BCN Commercial |
$537.80
|
| Rate for Payer: BCN Medicare Advantage |
$172.93
|
| Rate for Payer: Cash Price |
$553.37
|
| Rate for Payer: Cash Price |
$553.37
|
| Rate for Payer: Cofinity Commercial |
$594.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.93
|
| Rate for Payer: Healthscope Commercial |
$622.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.78
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.57
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.95
|
| Rate for Payer: Nomi Health Commercial |
$567.20
|
| Rate for Payer: PACE Senior Care Partners |
$164.28
|
| Rate for Payer: PACE SWMI |
$172.93
|
| Rate for Payer: PHP Commercial |
$587.95
|
| Rate for Payer: PHP Medicare Advantage |
$172.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.61
|
| Rate for Payer: Priority Health HMO/PPO |
$601.79
|
| Rate for Payer: Priority Health Medicare |
$174.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.45
|
| Rate for Payer: Railroad Medicare Medicare |
$172.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.70
|
| Rate for Payer: UHC Core |
$577.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.93
|
| Rate for Payer: UHC Exchange |
$172.93
|
| Rate for Payer: UHC Medicare Advantage |
$172.93
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$172.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.78
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
IP
|
$1,052.05
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$683.83 |
| Max. Negotiated Rate |
$946.85 |
| Rate for Payer: Aetna Commercial |
$894.24
|
| Rate for Payer: BCBS Trust/PPO |
$858.79
|
| Rate for Payer: BCN Commercial |
$813.02
|
| Rate for Payer: Cash Price |
$841.64
|
| Rate for Payer: Cofinity Commercial |
$904.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.64
|
| Rate for Payer: Healthscope Commercial |
$946.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.24
|
| Rate for Payer: Nomi Health Commercial |
$862.68
|
| Rate for Payer: PHP Commercial |
$894.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.83
|
| Rate for Payer: Priority Health HMO/PPO |
$915.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.80
|
| Rate for Payer: UHC Core |
$878.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.04
|
|
|
HC CT BRAIN PERFUSION
|
Facility
|
OP
|
$1,052.05
|
|
|
Service Code
|
CPT 0042T
|
| Hospital Charge Code |
35100011
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$249.86 |
| Max. Negotiated Rate |
$946.85 |
| Rate for Payer: Aetna Commercial |
$894.24
|
| Rate for Payer: Aetna Medicare |
$273.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.77
|
| Rate for Payer: BCBS Complete |
$420.82
|
| Rate for Payer: BCBS MAPPO |
$263.01
|
| Rate for Payer: BCBS Trust/PPO |
$864.89
|
| Rate for Payer: BCN Commercial |
$817.97
|
| Rate for Payer: BCN Medicare Advantage |
$263.01
|
| Rate for Payer: Cash Price |
$841.64
|
| Rate for Payer: Cofinity Commercial |
$904.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.01
|
| Rate for Payer: Healthscope Commercial |
$946.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.24
|
| Rate for Payer: Nomi Health Commercial |
$862.68
|
| Rate for Payer: PACE Senior Care Partners |
$249.86
|
| Rate for Payer: PACE SWMI |
$263.01
|
| Rate for Payer: PHP Commercial |
$894.24
|
| Rate for Payer: PHP Medicare Advantage |
$263.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.83
|
| Rate for Payer: Priority Health HMO/PPO |
$915.28
|
| Rate for Payer: Priority Health Medicare |
$265.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.87
|
| Rate for Payer: Railroad Medicare Medicare |
$263.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.80
|
| Rate for Payer: UHC Core |
$878.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.01
|
| Rate for Payer: UHC Exchange |
$263.01
|
| Rate for Payer: UHC Medicare Advantage |
$263.01
|
| Rate for Payer: VA VA |
$263.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.04
|
|
|
HC CT BRAIN W CON
|
Facility
|
OP
|
$1,622.71
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,460.44 |
| Rate for Payer: Aetna Commercial |
$1,379.30
|
| Rate for Payer: Aetna Medicare |
$421.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$507.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$507.10
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$405.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,334.03
|
| Rate for Payer: BCN Commercial |
$1,261.66
|
| Rate for Payer: BCN Medicare Advantage |
$405.68
|
| Rate for Payer: Cash Price |
$1,298.17
|
| Rate for Payer: Cash Price |
$1,298.17
|
| Rate for Payer: Cofinity Commercial |
$1,395.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.68
|
| Rate for Payer: Healthscope Commercial |
$1,460.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,217.03
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.96
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$466.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,379.30
|
| Rate for Payer: Nomi Health Commercial |
$1,330.62
|
| Rate for Payer: PACE Senior Care Partners |
$385.39
|
| Rate for Payer: PACE SWMI |
$405.68
|
| Rate for Payer: PHP Commercial |
$1,379.30
|
| Rate for Payer: PHP Medicare Advantage |
$405.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,054.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,411.76
|
| Rate for Payer: Priority Health Medicare |
$409.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,087.22
|
| Rate for Payer: Railroad Medicare Medicare |
$405.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,427.98
|
| Rate for Payer: UHC Core |
$1,354.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$405.68
|
| Rate for Payer: UHC Exchange |
$405.68
|
| Rate for Payer: UHC Medicare Advantage |
$405.68
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$405.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,217.03
|
|
|
HC CT BRAIN W CON
|
Facility
|
IP
|
$1,622.71
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
35100002
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,054.76 |
| Max. Negotiated Rate |
$1,460.44 |
| Rate for Payer: Aetna Commercial |
$1,379.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.62
|
| Rate for Payer: BCN Commercial |
$1,254.03
|
| Rate for Payer: Cash Price |
$1,298.17
|
| Rate for Payer: Cofinity Commercial |
$1,395.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,298.17
|
| Rate for Payer: Healthscope Commercial |
$1,460.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,217.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,379.30
|
| Rate for Payer: Nomi Health Commercial |
$1,330.62
|
| Rate for Payer: PHP Commercial |
$1,379.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,054.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,411.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,087.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,427.98
|
| Rate for Payer: UHC Core |
$1,354.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,217.03
|
|
|
HC CT BRAIN WO CON
|
Facility
|
OP
|
$1,514.14
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Aetna Commercial |
$1,287.02
|
| Rate for Payer: Aetna Medicare |
$393.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$473.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$473.17
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$378.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.77
|
| Rate for Payer: BCN Commercial |
$1,177.24
|
| Rate for Payer: BCN Medicare Advantage |
$378.54
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cofinity Commercial |
$1,302.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.54
|
| Rate for Payer: Healthscope Commercial |
$1,362.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.61
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.46
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$435.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,287.02
|
| Rate for Payer: Nomi Health Commercial |
$1,241.59
|
| Rate for Payer: PACE Senior Care Partners |
$359.61
|
| Rate for Payer: PACE SWMI |
$378.54
|
| Rate for Payer: PHP Commercial |
$1,287.02
|
| Rate for Payer: PHP Medicare Advantage |
$378.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,317.30
|
| Rate for Payer: Priority Health Medicare |
$382.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.47
|
| Rate for Payer: Railroad Medicare Medicare |
$378.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,332.44
|
| Rate for Payer: UHC Core |
$1,264.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.54
|
| Rate for Payer: UHC Exchange |
$378.54
|
| Rate for Payer: UHC Medicare Advantage |
$378.54
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$378.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.61
|
|
|
HC CT BRAIN WO CON
|
Facility
|
IP
|
$1,514.14
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
35100001
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$984.19 |
| Max. Negotiated Rate |
$1,362.73 |
| Rate for Payer: Aetna Commercial |
$1,287.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.99
|
| Rate for Payer: BCN Commercial |
$1,170.13
|
| Rate for Payer: Cash Price |
$1,211.31
|
| Rate for Payer: Cofinity Commercial |
$1,302.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.31
|
| Rate for Payer: Healthscope Commercial |
$1,362.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,287.02
|
| Rate for Payer: Nomi Health Commercial |
$1,241.59
|
| Rate for Payer: PHP Commercial |
$1,287.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,317.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,332.44
|
| Rate for Payer: UHC Core |
$1,264.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.61
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
OP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,643.31 |
| Rate for Payer: Aetna Commercial |
$1,552.02
|
| Rate for Payer: Aetna Medicare |
$474.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$570.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$570.59
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$456.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,501.07
|
| Rate for Payer: BCN Commercial |
$1,419.64
|
| Rate for Payer: BCN Medicare Advantage |
$456.48
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,570.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$456.48
|
| Rate for Payer: Healthscope Commercial |
$1,643.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,369.42
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.30
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$524.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: Nomi Health Commercial |
$1,497.24
|
| Rate for Payer: PACE Senior Care Partners |
$433.65
|
| Rate for Payer: PACE SWMI |
$456.48
|
| Rate for Payer: PHP Commercial |
$1,552.02
|
| Rate for Payer: PHP Medicare Advantage |
$456.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,588.53
|
| Rate for Payer: Priority Health Medicare |
$461.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,223.35
|
| Rate for Payer: Railroad Medicare Medicare |
$456.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.79
|
| Rate for Payer: UHC Core |
$1,524.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$456.48
|
| Rate for Payer: UHC Exchange |
$456.48
|
| Rate for Payer: UHC Medicare Advantage |
$456.48
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$456.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,369.42
|
|
|
HC CT BRAIN WO W CON
|
Facility
|
IP
|
$1,825.90
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
35100003
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,186.84 |
| Max. Negotiated Rate |
$1,643.31 |
| Rate for Payer: Aetna Commercial |
$1,552.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,490.48
|
| Rate for Payer: BCN Commercial |
$1,411.06
|
| Rate for Payer: Cash Price |
$1,460.72
|
| Rate for Payer: Cofinity Commercial |
$1,570.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,460.72
|
| Rate for Payer: Healthscope Commercial |
$1,643.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,369.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,552.02
|
| Rate for Payer: Nomi Health Commercial |
$1,497.24
|
| Rate for Payer: PHP Commercial |
$1,552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,186.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,588.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,223.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,606.79
|
| Rate for Payer: UHC Core |
$1,524.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,369.42
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
IP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,344.20 |
| Max. Negotiated Rate |
$1,861.20 |
| Rate for Payer: Aetna Commercial |
$1,757.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.11
|
| Rate for Payer: BCN Commercial |
$1,598.15
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,778.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Healthscope Commercial |
$1,861.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,551.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: Nomi Health Commercial |
$1,695.76
|
| Rate for Payer: PHP Commercial |
$1,757.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,799.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,385.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,819.84
|
| Rate for Payer: UHC Core |
$1,726.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,551.00
|
|
|
HC CT CHEST ANGIOGRAPHY
|
Facility
|
OP
|
$2,068.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
35000006
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,861.20 |
| Rate for Payer: Aetna Commercial |
$1,757.80
|
| Rate for Payer: Aetna Medicare |
$537.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.25
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$517.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.10
|
| Rate for Payer: BCN Commercial |
$1,607.87
|
| Rate for Payer: BCN Medicare Advantage |
$517.00
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cash Price |
$1,654.40
|
| Rate for Payer: Cofinity Commercial |
$1,778.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,654.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.00
|
| Rate for Payer: Healthscope Commercial |
$1,861.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,551.00
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$542.85
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$594.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,757.80
|
| Rate for Payer: Nomi Health Commercial |
$1,695.76
|
| Rate for Payer: PACE Senior Care Partners |
$491.15
|
| Rate for Payer: PACE SWMI |
$517.00
|
| Rate for Payer: PHP Commercial |
$1,757.80
|
| Rate for Payer: PHP Medicare Advantage |
$517.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,799.16
|
| Rate for Payer: Priority Health Medicare |
$522.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$517.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,819.84
|
| Rate for Payer: UHC Core |
$1,726.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.00
|
| Rate for Payer: UHC Exchange |
$517.00
|
| Rate for Payer: UHC Medicare Advantage |
$517.00
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$517.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,551.00
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
OP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$454.53 |
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$415.19
|
| Rate for Payer: BCN Commercial |
$392.66
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.77
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: Nomi Health Commercial |
$414.12
|
| Rate for Payer: PACE Senior Care Partners |
$119.94
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health HMO/PPO |
$439.38
|
| Rate for Payer: Priority Health Medicare |
$127.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.37
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.43
|
| Rate for Payer: UHC Core |
$421.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$126.26
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$126.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.77
|
|
|
HC CT CHEST SCREENING LUNG CANCER
|
Facility
|
IP
|
$505.03
|
|
|
Service Code
|
CPT 71271
|
| Hospital Charge Code |
35000040
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$328.27 |
| Max. Negotiated Rate |
$454.53 |
| Rate for Payer: Aetna Commercial |
$429.28
|
| Rate for Payer: BCBS Trust/PPO |
$412.26
|
| Rate for Payer: BCN Commercial |
$390.29
|
| Rate for Payer: Cash Price |
$404.02
|
| Rate for Payer: Cofinity Commercial |
$434.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.02
|
| Rate for Payer: Healthscope Commercial |
$454.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.28
|
| Rate for Payer: Nomi Health Commercial |
$414.12
|
| Rate for Payer: PHP Commercial |
$429.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.27
|
| Rate for Payer: Priority Health HMO/PPO |
$439.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.43
|
| Rate for Payer: UHC Core |
$421.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.77
|
|
|
HC CT CHEST WITH CON
|
Facility
|
OP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,563.43 |
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: Aetna Medicare |
$451.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$542.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$542.86
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$434.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.11
|
| Rate for Payer: BCN Commercial |
$1,350.63
|
| Rate for Payer: BCN Medicare Advantage |
$434.29
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.29
|
| Rate for Payer: Healthscope Commercial |
$1,563.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,302.86
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.00
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$499.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: Nomi Health Commercial |
$1,424.46
|
| Rate for Payer: PACE Senior Care Partners |
$412.57
|
| Rate for Payer: PACE SWMI |
$434.29
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: PHP Medicare Advantage |
$434.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,511.32
|
| Rate for Payer: Priority Health Medicare |
$438.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,163.89
|
| Rate for Payer: Railroad Medicare Medicare |
$434.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,528.69
|
| Rate for Payer: UHC Core |
$1,450.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.29
|
| Rate for Payer: UHC Exchange |
$434.29
|
| Rate for Payer: UHC Medicare Advantage |
$434.29
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$434.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,302.86
|
|
|
HC CT CHEST WITH CON
|
Facility
|
IP
|
$1,737.15
|
|
|
Service Code
|
CPT 71260
|
| Hospital Charge Code |
35200001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,129.15 |
| Max. Negotiated Rate |
$1,563.43 |
| Rate for Payer: Aetna Commercial |
$1,476.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,418.04
|
| Rate for Payer: BCN Commercial |
$1,342.47
|
| Rate for Payer: Cash Price |
$1,389.72
|
| Rate for Payer: Cofinity Commercial |
$1,493.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,389.72
|
| Rate for Payer: Healthscope Commercial |
$1,563.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,302.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,476.58
|
| Rate for Payer: Nomi Health Commercial |
$1,424.46
|
| Rate for Payer: PHP Commercial |
$1,476.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,511.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,163.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,528.69
|
| Rate for Payer: UHC Core |
$1,450.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,302.86
|
|
|
HC CT CHEST WO CON
|
Facility
|
OP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: Aetna Medicare |
$393.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$473.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$473.15
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$378.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.73
|
| Rate for Payer: BCN Commercial |
$1,177.20
|
| Rate for Payer: BCN Medicare Advantage |
$378.52
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.52
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.57
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.45
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$435.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$1,241.55
|
| Rate for Payer: PACE Senior Care Partners |
$359.60
|
| Rate for Payer: PACE SWMI |
$378.52
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: PHP Medicare Advantage |
$378.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,317.26
|
| Rate for Payer: Priority Health Medicare |
$382.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.44
|
| Rate for Payer: Railroad Medicare Medicare |
$378.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,332.40
|
| Rate for Payer: UHC Core |
$1,264.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.52
|
| Rate for Payer: UHC Exchange |
$378.52
|
| Rate for Payer: UHC Medicare Advantage |
$378.52
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$378.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.57
|
|
|
HC CT CHEST WO CON
|
Facility
|
IP
|
$1,514.09
|
|
|
Service Code
|
CPT 71250
|
| Hospital Charge Code |
35000005
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$984.16 |
| Max. Negotiated Rate |
$1,362.68 |
| Rate for Payer: Aetna Commercial |
$1,286.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.95
|
| Rate for Payer: BCN Commercial |
$1,170.09
|
| Rate for Payer: Cash Price |
$1,211.27
|
| Rate for Payer: Cofinity Commercial |
$1,302.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,211.27
|
| Rate for Payer: Healthscope Commercial |
$1,362.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,135.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,286.98
|
| Rate for Payer: Nomi Health Commercial |
$1,241.55
|
| Rate for Payer: PHP Commercial |
$1,286.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,317.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,332.40
|
| Rate for Payer: UHC Core |
$1,264.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,135.57
|
|
|
HC CT CHEST WO W CON
|
Facility
|
IP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,336.35 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.26
|
| Rate for Payer: BCN Commercial |
$1,588.82
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,788.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,377.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,809.22
|
| Rate for Payer: UHC Core |
$1,716.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.95
|
|
|
HC CT CHEST WO W CON
|
Facility
|
OP
|
$2,055.93
|
|
|
Service Code
|
CPT 71270
|
| Hospital Charge Code |
35200002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$128.71 |
| Max. Negotiated Rate |
$1,850.34 |
| Rate for Payer: Aetna Commercial |
$1,747.54
|
| Rate for Payer: Aetna Medicare |
$534.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$642.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$642.48
|
| Rate for Payer: BCBS Complete |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$513.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,690.18
|
| Rate for Payer: BCN Commercial |
$1,598.49
|
| Rate for Payer: BCN Medicare Advantage |
$513.98
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cash Price |
$1,644.74
|
| Rate for Payer: Cofinity Commercial |
$1,768.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,644.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.98
|
| Rate for Payer: Healthscope Commercial |
$1,850.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,541.95
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.68
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$591.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,747.54
|
| Rate for Payer: Nomi Health Commercial |
$1,685.86
|
| Rate for Payer: PACE Senior Care Partners |
$488.28
|
| Rate for Payer: PACE SWMI |
$513.98
|
| Rate for Payer: PHP Commercial |
$1,747.54
|
| Rate for Payer: PHP Medicare Advantage |
$513.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,788.66
|
| Rate for Payer: Priority Health Medicare |
$519.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,377.47
|
| Rate for Payer: Railroad Medicare Medicare |
$513.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,809.22
|
| Rate for Payer: UHC Core |
$1,716.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.98
|
| Rate for Payer: UHC Exchange |
$513.98
|
| Rate for Payer: UHC Medicare Advantage |
$513.98
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$513.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,541.95
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$897.27 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.83
|
| Rate for Payer: BCN Commercial |
$1,066.78
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,200.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.76
|
| Rate for Payer: UHC Core |
$1,152.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.31
|
|
|
HC CT CORONARY ANGIO
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
35000019
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$1,242.37 |
| Rate for Payer: Aetna Commercial |
$1,173.35
|
| Rate for Payer: Aetna Medicare |
$358.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.38
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$345.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.84
|
| Rate for Payer: BCN Commercial |
$1,073.27
|
| Rate for Payer: BCN Medicare Advantage |
$345.10
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cash Price |
$1,104.33
|
| Rate for Payer: Cofinity Commercial |
$1,187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.10
|
| Rate for Payer: Healthscope Commercial |
$1,242.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.31
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.36
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$396.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.35
|
| Rate for Payer: Nomi Health Commercial |
$1,131.94
|
| Rate for Payer: PACE Senior Care Partners |
$327.85
|
| Rate for Payer: PACE SWMI |
$345.10
|
| Rate for Payer: PHP Commercial |
$1,173.35
|
| Rate for Payer: PHP Medicare Advantage |
$345.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,200.96
|
| Rate for Payer: Priority Health Medicare |
$348.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.87
|
| Rate for Payer: Railroad Medicare Medicare |
$345.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.76
|
| Rate for Payer: UHC Core |
$1,152.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.10
|
| Rate for Payer: UHC Exchange |
$345.10
|
| Rate for Payer: UHC Medicare Advantage |
$345.10
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$345.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.31
|
|
