|
HC CT HEAD ANGIO
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: BCBS Trust/PPO |
$891.74
|
| Rate for Payer: BCN Commercial |
$844.22
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC CT HEAD ANGIO
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
35100010
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna Medicare |
$284.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.38
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$273.10
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$849.36
|
| Rate for Payer: BCN Medicare Advantage |
$273.10
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.10
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.76
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PACE Senior Care Partners |
$259.45
|
| Rate for Payer: PACE SWMI |
$273.10
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Medicare |
$275.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: Railroad Medicare Medicare |
$273.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.10
|
| Rate for Payer: UHC Exchange |
$273.10
|
| Rate for Payer: UHC Medicare Advantage |
$273.10
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$273.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC CT HEART SCAN
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
35000015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: BCBS Trust/PPO |
$163.26
|
| Rate for Payer: BCN Commercial |
$154.56
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health HMO/PPO |
$174.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.00
|
| Rate for Payer: UHC Core |
$167.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
HC CT HEART SCAN
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
35000015
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$47.50 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$170.00
|
| Rate for Payer: Aetna Medicare |
$52.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.50
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$164.42
|
| Rate for Payer: BCN Commercial |
$155.50
|
| Rate for Payer: BCN Medicare Advantage |
$50.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$172.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.00
|
| Rate for Payer: Healthscope Commercial |
$180.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.00
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.50
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.00
|
| Rate for Payer: Nomi Health Commercial |
$164.00
|
| Rate for Payer: PACE Senior Care Partners |
$47.50
|
| Rate for Payer: PACE SWMI |
$50.00
|
| Rate for Payer: PHP Commercial |
$170.00
|
| Rate for Payer: PHP Medicare Advantage |
$50.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.00
|
| Rate for Payer: Priority Health HMO/PPO |
$174.00
|
| Rate for Payer: Priority Health Medicare |
$50.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.00
|
| Rate for Payer: Railroad Medicare Medicare |
$50.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.00
|
| Rate for Payer: UHC Core |
$167.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.00
|
| Rate for Payer: UHC Exchange |
$50.00
|
| Rate for Payer: UHC Medicare Advantage |
$50.00
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$50.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.00
|
|
|
HC CT HEART W CON CONGEN HEART DI
|
Facility
|
IP
|
$1,353.34
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
35000017
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$879.67 |
| Max. Negotiated Rate |
$1,218.01 |
| Rate for Payer: Aetna Commercial |
$1,150.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.73
|
| Rate for Payer: BCN Commercial |
$1,045.86
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Healthscope Commercial |
$1,218.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,015.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.34
|
| Rate for Payer: Nomi Health Commercial |
$1,109.74
|
| Rate for Payer: PHP Commercial |
$1,150.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,177.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.94
|
| Rate for Payer: UHC Core |
$1,130.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,015.00
|
|
|
HC CT HEART W CON CONGEN HEART DI
|
Facility
|
OP
|
$1,353.34
|
|
|
Service Code
|
CPT 75573
|
| Hospital Charge Code |
35000017
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,218.01 |
| Rate for Payer: Aetna Commercial |
$1,150.34
|
| Rate for Payer: Aetna Medicare |
$351.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$422.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$422.92
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$338.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.58
|
| Rate for Payer: BCN Commercial |
$1,052.22
|
| Rate for Payer: BCN Medicare Advantage |
$338.34
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cash Price |
$1,082.67
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.34
|
| Rate for Payer: Healthscope Commercial |
$1,218.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,015.00
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.25
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$389.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,150.34
|
| Rate for Payer: Nomi Health Commercial |
$1,109.74
|
| Rate for Payer: PACE Senior Care Partners |
$321.42
|
| Rate for Payer: PACE SWMI |
$338.34
|
| Rate for Payer: PHP Commercial |
$1,150.34
|
| Rate for Payer: PHP Medicare Advantage |
$338.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$879.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,177.41
|
| Rate for Payer: Priority Health Medicare |
$341.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.74
|
| Rate for Payer: Railroad Medicare Medicare |
$338.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.94
|
| Rate for Payer: UHC Core |
$1,130.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.34
|
| Rate for Payer: UHC Exchange |
$338.34
|
| Rate for Payer: UHC Medicare Advantage |
$338.34
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$338.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,015.00
|
|
|
HC CT HEART WITH CONTRAST
|
Facility
|
IP
|
$1,380.41
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
35000016
|
|
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 HEART WITH CONTRAST
|
Facility
|
OP
|
$1,380.41
|
|
|
Service Code
|
CPT 75572
|
| Hospital Charge Code |
35000016
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$252.98 |
| 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 |
$265.65
|
| 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 |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.36
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| 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 |
$252.98
|
| 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 |
$252.98
|
| Rate for Payer: VA VA |
$345.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.31
|
|
|
HC CT LIMITED OR FOLLOW-UP
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000022
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$183.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$548.52
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.37
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT LIMITED OR FOLLOW-UP
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000022
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: BCBS Trust/PPO |
$575.89
|
| Rate for Payer: BCN Commercial |
$545.20
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT LOWER EXTREM ANGIO
|
Facility
|
IP
|
$1,904.14
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
35000011
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,237.69 |
| Max. Negotiated Rate |
$1,713.73 |
| Rate for Payer: Aetna Commercial |
$1,618.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,554.35
|
| Rate for Payer: BCN Commercial |
$1,471.52
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cofinity Commercial |
$1,637.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.31
|
| Rate for Payer: Healthscope Commercial |
$1,713.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,618.52
|
| Rate for Payer: Nomi Health Commercial |
$1,561.39
|
| Rate for Payer: PHP Commercial |
$1,618.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,656.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.64
|
| Rate for Payer: UHC Core |
$1,589.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.10
|
|
|
HC CT LOWER EXTREM ANGIO
|
Facility
|
OP
|
$1,904.14
|
|
|
Service Code
|
CPT 73706
|
| Hospital Charge Code |
35000011
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,713.73 |
| Rate for Payer: Aetna Commercial |
$1,618.52
|
| Rate for Payer: Aetna Medicare |
$495.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.04
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$476.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.39
|
| Rate for Payer: BCN Commercial |
$1,480.47
|
| Rate for Payer: BCN Medicare Advantage |
$476.04
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cash Price |
$1,523.31
|
| Rate for Payer: Cofinity Commercial |
$1,637.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.04
|
| Rate for Payer: Healthscope Commercial |
$1,713.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.10
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$499.84
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,618.52
|
| Rate for Payer: Nomi Health Commercial |
$1,561.39
|
| Rate for Payer: PACE Senior Care Partners |
$452.23
|
| Rate for Payer: PACE SWMI |
$476.04
|
| Rate for Payer: PHP Commercial |
$1,618.52
|
| Rate for Payer: PHP Medicare Advantage |
$476.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,237.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,656.60
|
| Rate for Payer: Priority Health Medicare |
$480.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.77
|
| Rate for Payer: Railroad Medicare Medicare |
$476.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,675.64
|
| Rate for Payer: UHC Core |
$1,589.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.04
|
| Rate for Payer: UHC Exchange |
$476.04
|
| Rate for Payer: UHC Medicare Advantage |
$476.04
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$476.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.10
|
|
|
HC CT LOWER EXTREM BILAT W CON
|
Facility
|
OP
|
$1,611.38
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200030
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,450.24 |
| Rate for Payer: Aetna Commercial |
$1,369.67
|
| Rate for Payer: Aetna Medicare |
$418.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.56
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$402.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.72
|
| Rate for Payer: BCN Commercial |
$1,252.85
|
| Rate for Payer: BCN Medicare Advantage |
$402.84
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,385.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,289.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.84
|
| Rate for Payer: Healthscope Commercial |
$1,450.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,208.54
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.99
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$463.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,369.67
|
| Rate for Payer: Nomi Health Commercial |
$1,321.33
|
| Rate for Payer: PACE Senior Care Partners |
$382.70
|
| Rate for Payer: PACE SWMI |
$402.84
|
| Rate for Payer: PHP Commercial |
$1,369.67
|
| Rate for Payer: PHP Medicare Advantage |
$402.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,401.90
|
| Rate for Payer: Priority Health Medicare |
$406.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,079.62
|
| Rate for Payer: Railroad Medicare Medicare |
$402.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,418.01
|
| Rate for Payer: UHC Core |
$1,345.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.84
|
| Rate for Payer: UHC Exchange |
$402.84
|
| Rate for Payer: UHC Medicare Advantage |
$402.84
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$402.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,208.54
|
|
|
HC CT LOWER EXTREM BILAT W CON
|
Facility
|
IP
|
$1,611.38
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200030
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,047.40 |
| Max. Negotiated Rate |
$1,450.24 |
| Rate for Payer: Aetna Commercial |
$1,369.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.37
|
| Rate for Payer: BCN Commercial |
$1,245.27
|
| Rate for Payer: Cash Price |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,385.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,289.10
|
| Rate for Payer: Healthscope Commercial |
$1,450.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,208.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,369.67
|
| Rate for Payer: Nomi Health Commercial |
$1,321.33
|
| Rate for Payer: PHP Commercial |
$1,369.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,401.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,079.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,418.01
|
| Rate for Payer: UHC Core |
$1,345.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,208.54
|
|
|
HC CT LOWER EXTREM BILAT WO CON
|
Facility
|
IP
|
$1,376.45
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200017
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$894.69 |
| Max. Negotiated Rate |
$1,238.80 |
| Rate for Payer: Aetna Commercial |
$1,169.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,123.60
|
| Rate for Payer: BCN Commercial |
$1,063.72
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cofinity Commercial |
$1,183.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.16
|
| Rate for Payer: Healthscope Commercial |
$1,238.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.98
|
| Rate for Payer: Nomi Health Commercial |
$1,128.69
|
| Rate for Payer: PHP Commercial |
$1,169.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.28
|
| Rate for Payer: UHC Core |
$1,149.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.34
|
|
|
HC CT LOWER EXTREM BILAT WO CON
|
Facility
|
OP
|
$1,376.45
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200017
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,238.80 |
| Rate for Payer: Aetna Commercial |
$1,169.98
|
| Rate for Payer: Aetna Medicare |
$357.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.14
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$344.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.58
|
| Rate for Payer: BCN Commercial |
$1,070.19
|
| Rate for Payer: BCN Medicare Advantage |
$344.11
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cash Price |
$1,101.16
|
| Rate for Payer: Cofinity Commercial |
$1,183.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.11
|
| Rate for Payer: Healthscope Commercial |
$1,238.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.34
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.32
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.98
|
| Rate for Payer: Nomi Health Commercial |
$1,128.69
|
| Rate for Payer: PACE Senior Care Partners |
$326.91
|
| Rate for Payer: PACE SWMI |
$344.11
|
| Rate for Payer: PHP Commercial |
$1,169.98
|
| Rate for Payer: PHP Medicare Advantage |
$344.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$894.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.51
|
| Rate for Payer: Priority Health Medicare |
$347.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.22
|
| Rate for Payer: Railroad Medicare Medicare |
$344.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.28
|
| Rate for Payer: UHC Core |
$1,149.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.11
|
| Rate for Payer: UHC Exchange |
$344.11
|
| Rate for Payer: UHC Medicare Advantage |
$344.11
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$344.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.34
|
|
|
HC CT LOWER EXTREM BILAT WO W CON
|
Facility
|
OP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200020
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: Aetna Medicare |
$453.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.54
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$436.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.16
|
| Rate for Payer: BCN Commercial |
$1,357.31
|
| Rate for Payer: BCN Medicare Advantage |
$436.43
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.43
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.25
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$501.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: PACE Senior Care Partners |
$414.61
|
| Rate for Payer: PACE SWMI |
$436.43
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: PHP Medicare Advantage |
$436.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Medicare |
$440.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: Railroad Medicare Medicare |
$436.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.43
|
| Rate for Payer: UHC Exchange |
$436.43
|
| Rate for Payer: UHC Medicare Advantage |
$436.43
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$436.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
|
|
HC CT LOWER EXTREM BILAT WO W CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200020
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,425.04
|
| Rate for Payer: BCN Commercial |
$1,349.10
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
|
|
HC CT LOWER EXTREM BIL W CON
|
Facility
|
IP
|
$2,061.33
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200032
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,339.86 |
| Max. Negotiated Rate |
$1,855.20 |
| Rate for Payer: Aetna Commercial |
$1,752.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.66
|
| Rate for Payer: BCN Commercial |
$1,593.00
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cofinity Commercial |
$1,772.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.06
|
| Rate for Payer: Healthscope Commercial |
$1,855.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,546.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,752.13
|
| Rate for Payer: Nomi Health Commercial |
$1,690.29
|
| Rate for Payer: PHP Commercial |
$1,752.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,793.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,381.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,813.97
|
| Rate for Payer: UHC Core |
$1,721.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,546.00
|
|
|
HC CT LOWER EXTREM BIL W CON
|
Facility
|
OP
|
$2,061.33
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200032
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,855.20 |
| Rate for Payer: Aetna Commercial |
$1,752.13
|
| Rate for Payer: Aetna Medicare |
$535.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$644.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$644.17
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$515.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.62
|
| Rate for Payer: BCN Commercial |
$1,602.68
|
| Rate for Payer: BCN Medicare Advantage |
$515.33
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cash Price |
$1,649.06
|
| Rate for Payer: Cofinity Commercial |
$1,772.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,649.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.33
|
| Rate for Payer: Healthscope Commercial |
$1,855.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,546.00
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.10
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$592.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,752.13
|
| Rate for Payer: Nomi Health Commercial |
$1,690.29
|
| Rate for Payer: PACE Senior Care Partners |
$489.57
|
| Rate for Payer: PACE SWMI |
$515.33
|
| Rate for Payer: PHP Commercial |
$1,752.13
|
| Rate for Payer: PHP Medicare Advantage |
$515.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,793.36
|
| Rate for Payer: Priority Health Medicare |
$520.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,381.09
|
| Rate for Payer: Railroad Medicare Medicare |
$515.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,813.97
|
| Rate for Payer: UHC Core |
$1,721.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.33
|
| Rate for Payer: UHC Exchange |
$515.33
|
| Rate for Payer: UHC Medicare Advantage |
$515.33
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$515.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,546.00
|
|
|
HC CT LOWER EXTREM BIL WO CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200031
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,425.04
|
| Rate for Payer: BCN Commercial |
$1,349.10
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
|
|
HC CT LOWER EXTREM BIL WO CON
|
Facility
|
OP
|
$1,745.73
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200031
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: Aetna Medicare |
$453.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.54
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$436.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.16
|
| Rate for Payer: BCN Commercial |
$1,357.31
|
| Rate for Payer: BCN Medicare Advantage |
$436.43
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.43
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.25
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$501.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: PACE Senior Care Partners |
$414.61
|
| Rate for Payer: PACE SWMI |
$436.43
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: PHP Medicare Advantage |
$436.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Medicare |
$440.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: Railroad Medicare Medicare |
$436.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.43
|
| Rate for Payer: UHC Exchange |
$436.43
|
| Rate for Payer: UHC Medicare Advantage |
$436.43
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$436.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
|
|
HC CT LOWER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200019
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,134.72 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: Aetna Commercial |
$2,225.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,425.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,137.56
|
| Rate for Payer: BCN Commercial |
$1,349.10
|
| Rate for Payer: BCN Commercial |
$2,023.65
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cofinity Commercial |
$2,251.99
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,094.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Healthscope Commercial |
$2,356.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,963.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,225.80
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Nomi Health Commercial |
$2,147.24
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: PHP Commercial |
$2,225.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health HMO/PPO |
$2,278.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,754.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,304.36
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: UHC Core |
$2,186.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,963.94
|
|
|
HC CT LOWER EXTREMITY WO W CON
|
Facility
|
OP
|
$1,745.73
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200019
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,571.16 |
| Rate for Payer: Aetna Commercial |
$1,483.87
|
| Rate for Payer: Aetna Commercial |
$2,225.80
|
| Rate for Payer: Aetna Medicare |
$453.89
|
| Rate for Payer: Aetna Medicare |
$680.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$818.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$818.31
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$654.65
|
| Rate for Payer: BCBS MAPPO |
$436.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,435.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,152.74
|
| Rate for Payer: BCN Commercial |
$1,357.31
|
| Rate for Payer: BCN Commercial |
$2,035.95
|
| Rate for Payer: BCN Medicare Advantage |
$436.43
|
| Rate for Payer: BCN Medicare Advantage |
$654.65
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$2,094.87
|
| Rate for Payer: Cofinity Commercial |
$1,501.33
|
| Rate for Payer: Cofinity Commercial |
$2,251.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,094.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.65
|
| Rate for Payer: Healthscope Commercial |
$2,356.73
|
| Rate for Payer: Healthscope Commercial |
$1,571.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,309.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,963.94
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$687.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.25
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$501.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,483.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,225.80
|
| Rate for Payer: Nomi Health Commercial |
$1,431.50
|
| Rate for Payer: Nomi Health Commercial |
$2,147.24
|
| Rate for Payer: PACE Senior Care Partners |
$414.61
|
| Rate for Payer: PACE Senior Care Partners |
$621.92
|
| Rate for Payer: PACE SWMI |
$436.43
|
| Rate for Payer: PACE SWMI |
$654.65
|
| Rate for Payer: PHP Commercial |
$2,225.80
|
| Rate for Payer: PHP Commercial |
$1,483.87
|
| Rate for Payer: PHP Medicare Advantage |
$436.43
|
| Rate for Payer: PHP Medicare Advantage |
$654.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,134.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,702.08
|
| Rate for Payer: Priority Health HMO/PPO |
$2,278.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,518.79
|
| Rate for Payer: Priority Health Medicare |
$440.80
|
| Rate for Payer: Priority Health Medicare |
$661.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,754.46
|
| Rate for Payer: Railroad Medicare Medicare |
$654.65
|
| Rate for Payer: Railroad Medicare Medicare |
$436.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,304.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,536.24
|
| Rate for Payer: UHC Core |
$2,186.52
|
| Rate for Payer: UHC Core |
$1,457.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$654.65
|
| Rate for Payer: UHC Exchange |
$654.65
|
| Rate for Payer: UHC Exchange |
$436.43
|
| Rate for Payer: UHC Medicare Advantage |
$654.65
|
| Rate for Payer: UHC Medicare Advantage |
$436.43
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$436.43
|
| Rate for Payer: VA VA |
$654.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,309.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,963.94
|
|
|
HC CT LOWER EXTREM W CON
|
Facility
|
IP
|
$1,545.62
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200018
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,004.65 |
| Max. Negotiated Rate |
$1,391.06 |
| Rate for Payer: Aetna Commercial |
$1,313.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.69
|
| Rate for Payer: BCN Commercial |
$1,194.46
|
| Rate for Payer: Cash Price |
$1,236.50
|
| Rate for Payer: Cofinity Commercial |
$1,329.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.50
|
| Rate for Payer: Healthscope Commercial |
$1,391.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.78
|
| Rate for Payer: Nomi Health Commercial |
$1,267.41
|
| Rate for Payer: PHP Commercial |
$1,313.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,004.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,344.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,035.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.15
|
| Rate for Payer: UHC Core |
$1,290.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.22
|
|
