|
HC CT LOWER EXTREM W CON
|
Facility
|
OP
|
$1,545.62
|
|
|
Service Code
|
CPT 73701
|
| Hospital Charge Code |
35200018
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,391.06 |
| Rate for Payer: Aetna Commercial |
$1,313.78
|
| Rate for Payer: Aetna Medicare |
$401.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$483.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$483.01
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$386.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,270.65
|
| Rate for Payer: BCN Commercial |
$1,201.72
|
| Rate for Payer: BCN Medicare Advantage |
$386.40
|
| Rate for Payer: Cash Price |
$1,236.50
|
| 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: Health Alliance Plan Medicare Advantage |
$386.40
|
| Rate for Payer: Healthscope Commercial |
$1,391.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.22
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$405.73
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$444.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,313.78
|
| Rate for Payer: Nomi Health Commercial |
$1,267.41
|
| Rate for Payer: PACE Senior Care Partners |
$367.08
|
| Rate for Payer: PACE SWMI |
$386.40
|
| Rate for Payer: PHP Commercial |
$1,313.78
|
| Rate for Payer: PHP Medicare Advantage |
$386.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| 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 Medicare |
$390.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,035.57
|
| Rate for Payer: Railroad Medicare Medicare |
$386.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.15
|
| Rate for Payer: UHC Core |
$1,290.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.40
|
| Rate for Payer: UHC Exchange |
$386.40
|
| Rate for Payer: UHC Medicare Advantage |
$386.40
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$386.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.22
|
|
|
HC CT LOWER EXTREM WO CON
|
Facility
|
IP
|
$1,349.46
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200016
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$877.15 |
| Max. Negotiated Rate |
$1,214.51 |
| Rate for Payer: Aetna Commercial |
$1,147.04
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,652.35
|
| Rate for Payer: BCN Commercial |
$1,042.86
|
| Rate for Payer: BCN Commercial |
$1,564.29
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Cofinity Commercial |
$1,160.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.57
|
| Rate for Payer: Healthscope Commercial |
$1,214.51
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,720.56
|
| Rate for Payer: Nomi Health Commercial |
$1,106.56
|
| Rate for Payer: Nomi Health Commercial |
$1,659.84
|
| Rate for Payer: PHP Commercial |
$1,147.04
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$877.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,761.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,174.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$904.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,781.29
|
| Rate for Payer: UHC Core |
$1,126.80
|
| Rate for Payer: UHC Core |
$1,690.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC CT LOWER EXTREM WO CON
|
Facility
|
OP
|
$1,349.46
|
|
|
Service Code
|
CPT 73700
|
| Hospital Charge Code |
35200016
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,214.51 |
| Rate for Payer: Aetna Commercial |
$1,147.04
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: Aetna Medicare |
$350.86
|
| Rate for Payer: Aetna Medicare |
$526.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$421.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$632.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$421.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$632.56
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$506.05
|
| Rate for Payer: BCBS MAPPO |
$337.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.09
|
| Rate for Payer: BCN Commercial |
$1,049.21
|
| Rate for Payer: BCN Commercial |
$1,573.81
|
| Rate for Payer: BCN Medicare Advantage |
$337.36
|
| Rate for Payer: BCN Medicare Advantage |
$506.05
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cash Price |
$1,079.57
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,160.54
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.05
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Healthscope Commercial |
$1,214.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$354.23
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$581.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,147.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,720.56
|
| Rate for Payer: Nomi Health Commercial |
$1,106.56
|
| Rate for Payer: Nomi Health Commercial |
$1,659.84
|
| Rate for Payer: PACE Senior Care Partners |
$320.50
|
| Rate for Payer: PACE Senior Care Partners |
$480.75
|
| Rate for Payer: PACE SWMI |
$337.36
|
| Rate for Payer: PACE SWMI |
$506.05
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: PHP Commercial |
$1,147.04
|
| Rate for Payer: PHP Medicare Advantage |
$337.36
|
| Rate for Payer: PHP Medicare Advantage |
$506.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$877.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,315.72
|
| Rate for Payer: Priority Health HMO/PPO |
$1,761.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,174.03
|
| Rate for Payer: Priority Health Medicare |
$340.74
|
| Rate for Payer: Priority Health Medicare |
$511.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$904.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.21
|
| Rate for Payer: Railroad Medicare Medicare |
$506.05
|
| Rate for Payer: Railroad Medicare Medicare |
$337.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,781.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,187.52
|
| Rate for Payer: UHC Core |
$1,690.20
|
| Rate for Payer: UHC Core |
$1,126.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.05
|
| Rate for Payer: UHC Exchange |
$506.05
|
| Rate for Payer: UHC Exchange |
$337.36
|
| Rate for Payer: UHC Medicare Advantage |
$506.05
|
| Rate for Payer: UHC Medicare Advantage |
$337.36
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$337.36
|
| Rate for Payer: VA VA |
$506.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC CT LOWER EXTREM WO W CON
|
Facility
|
OP
|
$1,037.49
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200029
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$933.74 |
| Rate for Payer: Aetna Commercial |
$881.87
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: Aetna Medicare |
$269.75
|
| Rate for Payer: Aetna Medicare |
$179.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$324.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$216.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$324.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$216.14
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$172.92
|
| Rate for Payer: BCBS MAPPO |
$259.37
|
| Rate for Payer: BCBS Trust/PPO |
$852.92
|
| Rate for Payer: BCBS Trust/PPO |
$568.61
|
| Rate for Payer: BCN Commercial |
$806.65
|
| Rate for Payer: BCN Commercial |
$537.77
|
| Rate for Payer: BCN Medicare Advantage |
$259.37
|
| Rate for Payer: BCN Medicare Advantage |
$172.92
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cash Price |
$829.99
|
| Rate for Payer: Cash Price |
$829.99
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$892.24
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.92
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Healthscope Commercial |
$933.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$778.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| 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 |
$181.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.34
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.91
|
| Rate for Payer: Nomi Health Commercial |
$850.74
|
| Rate for Payer: Nomi Health Commercial |
$567.16
|
| Rate for Payer: PACE Senior Care Partners |
$246.40
|
| Rate for Payer: PACE Senior Care Partners |
$164.27
|
| Rate for Payer: PACE SWMI |
$259.37
|
| Rate for Payer: PACE SWMI |
$172.92
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: PHP Commercial |
$881.87
|
| Rate for Payer: PHP Medicare Advantage |
$259.37
|
| Rate for Payer: PHP Medicare Advantage |
$172.92
|
| 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 |
$674.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.58
|
| Rate for Payer: Priority Health HMO/PPO |
$601.74
|
| Rate for Payer: Priority Health HMO/PPO |
$902.62
|
| Rate for Payer: Priority Health Medicare |
$261.97
|
| Rate for Payer: Priority Health Medicare |
$174.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$695.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.41
|
| Rate for Payer: Railroad Medicare Medicare |
$172.92
|
| Rate for Payer: Railroad Medicare Medicare |
$259.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.99
|
| Rate for Payer: UHC Core |
$577.54
|
| Rate for Payer: UHC Core |
$866.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.92
|
| Rate for Payer: UHC Exchange |
$172.92
|
| Rate for Payer: UHC Exchange |
$259.37
|
| Rate for Payer: UHC Medicare Advantage |
$172.92
|
| Rate for Payer: UHC Medicare Advantage |
$259.37
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$259.37
|
| Rate for Payer: VA VA |
$172.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$778.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT LOWER EXTREM WO W CON
|
Facility
|
IP
|
$1,037.49
|
|
|
Service Code
|
CPT 73702
|
| Hospital Charge Code |
35200029
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$674.37 |
| Max. Negotiated Rate |
$933.74 |
| Rate for Payer: Aetna Commercial |
$881.87
|
| Rate for Payer: Aetna Commercial |
$587.91
|
| Rate for Payer: BCBS Trust/PPO |
$846.90
|
| Rate for Payer: BCBS Trust/PPO |
$564.60
|
| Rate for Payer: BCN Commercial |
$801.77
|
| Rate for Payer: BCN Commercial |
$534.51
|
| Rate for Payer: Cash Price |
$829.99
|
| Rate for Payer: Cash Price |
$553.33
|
| Rate for Payer: Cofinity Commercial |
$594.83
|
| Rate for Payer: Cofinity Commercial |
$892.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.99
|
| Rate for Payer: Healthscope Commercial |
$933.74
|
| Rate for Payer: Healthscope Commercial |
$622.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$778.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.91
|
| Rate for Payer: Nomi Health Commercial |
$850.74
|
| Rate for Payer: Nomi Health Commercial |
$567.16
|
| Rate for Payer: PHP Commercial |
$881.87
|
| Rate for Payer: PHP Commercial |
$587.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.37
|
| Rate for Payer: Priority Health HMO/PPO |
$601.74
|
| Rate for Payer: Priority Health HMO/PPO |
$902.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$695.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.66
|
| Rate for Payer: UHC Core |
$866.30
|
| Rate for Payer: UHC Core |
$577.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$778.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC CT NECK ANGIO
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
35000004
|
|
Hospital Revenue Code
|
350
|
| 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 NECK ANGIO
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 70498
|
| Hospital Charge Code |
35000004
|
|
Hospital Revenue Code
|
350
|
| 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 NEEDLE PLACE HEAD AND NECK
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 41019
|
| Hospital Charge Code |
36100396
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.33
|
| Rate for Payer: BCN Commercial |
$2,974.88
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC CT NEEDLE PLACE HEAD AND NECK
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 41019
|
| Hospital Charge Code |
36100396
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.25 |
| Max. Negotiated Rate |
$4,400.36 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$1,000.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,202.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,202.96
|
| Rate for Payer: BCBS Complete |
$4,400.36
|
| Rate for Payer: BCBS MAPPO |
$962.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.66
|
| Rate for Payer: BCN Commercial |
$2,992.97
|
| Rate for Payer: BCN Medicare Advantage |
$962.37
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.37
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Mclaren Medicaid |
$4,190.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$4,400.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,106.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Senior Care Partners |
$914.25
|
| Rate for Payer: PACE SWMI |
$962.37
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$962.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,190.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Medicare |
$971.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.37
|
| Rate for Payer: UHC Exchange |
$962.37
|
| Rate for Payer: UHC Medicare Advantage |
$962.37
|
| Rate for Payer: UHCCP Medicaid |
$4,190.54
|
| Rate for Payer: VA VA |
$962.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC CTO CATHETER
|
Facility
|
OP
|
$6,462.07
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,534.74 |
| Max. Negotiated Rate |
$5,815.86 |
| Rate for Payer: Aetna Commercial |
$5,492.76
|
| Rate for Payer: Aetna Medicare |
$1,680.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,019.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,019.40
|
| Rate for Payer: BCBS Complete |
$2,584.83
|
| Rate for Payer: BCBS MAPPO |
$1,615.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,312.47
|
| Rate for Payer: BCN Commercial |
$5,024.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,615.52
|
| Rate for Payer: Cash Price |
$5,169.66
|
| Rate for Payer: Cofinity Commercial |
$5,557.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,169.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,615.52
|
| Rate for Payer: Healthscope Commercial |
$5,815.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,846.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,696.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,857.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,492.76
|
| Rate for Payer: Nomi Health Commercial |
$5,298.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,534.74
|
| Rate for Payer: PACE SWMI |
$1,615.52
|
| Rate for Payer: PHP Commercial |
$5,492.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,615.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,200.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,622.00
|
| Rate for Payer: Priority Health Medicare |
$1,631.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,329.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,615.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,686.62
|
| Rate for Payer: UHC Core |
$5,395.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,615.52
|
| Rate for Payer: UHC Exchange |
$1,615.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,615.52
|
| Rate for Payer: VA VA |
$1,615.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,846.55
|
|
|
HC CTO CATHETER
|
Facility
|
IP
|
$6,462.07
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,200.35 |
| Max. Negotiated Rate |
$5,815.86 |
| Rate for Payer: Aetna Commercial |
$5,492.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,274.99
|
| Rate for Payer: BCN Commercial |
$4,993.89
|
| Rate for Payer: Cash Price |
$5,169.66
|
| Rate for Payer: Cofinity Commercial |
$5,557.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,169.66
|
| Rate for Payer: Healthscope Commercial |
$5,815.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,846.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,492.76
|
| Rate for Payer: Nomi Health Commercial |
$5,298.90
|
| Rate for Payer: PHP Commercial |
$5,492.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,200.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,622.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,329.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,686.62
|
| Rate for Payer: UHC Core |
$5,395.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,846.55
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
OP
|
$1,579.64
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,421.68 |
| Rate for Payer: Aetna Commercial |
$1,342.69
|
| Rate for Payer: Aetna Medicare |
$410.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$493.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$493.64
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$394.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.62
|
| Rate for Payer: BCN Commercial |
$1,228.17
|
| Rate for Payer: BCN Medicare Advantage |
$394.91
|
| Rate for Payer: Cash Price |
$1,263.71
|
| Rate for Payer: Cash Price |
$1,263.71
|
| Rate for Payer: Cofinity Commercial |
$1,358.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.91
|
| Rate for Payer: Healthscope Commercial |
$1,421.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,184.73
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.66
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$454.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.69
|
| Rate for Payer: Nomi Health Commercial |
$1,295.30
|
| Rate for Payer: PACE Senior Care Partners |
$375.16
|
| Rate for Payer: PACE SWMI |
$394.91
|
| Rate for Payer: PHP Commercial |
$1,342.69
|
| Rate for Payer: PHP Medicare Advantage |
$394.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.77
|
| Rate for Payer: Priority Health HMO/PPO |
$1,374.29
|
| Rate for Payer: Priority Health Medicare |
$398.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,058.36
|
| Rate for Payer: Railroad Medicare Medicare |
$394.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,390.08
|
| Rate for Payer: UHC Core |
$1,319.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.91
|
| Rate for Payer: UHC Exchange |
$394.91
|
| Rate for Payer: UHC Medicare Advantage |
$394.91
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$394.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,184.73
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
IP
|
$1,579.64
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,026.77 |
| Max. Negotiated Rate |
$1,421.68 |
| Rate for Payer: Aetna Commercial |
$1,342.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.46
|
| Rate for Payer: BCN Commercial |
$1,220.75
|
| Rate for Payer: Cash Price |
$1,263.71
|
| Rate for Payer: Cofinity Commercial |
$1,358.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,263.71
|
| Rate for Payer: Healthscope Commercial |
$1,421.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,184.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,342.69
|
| Rate for Payer: Nomi Health Commercial |
$1,295.30
|
| Rate for Payer: PHP Commercial |
$1,342.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.77
|
| Rate for Payer: Priority Health HMO/PPO |
$1,374.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,058.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,390.08
|
| Rate for Payer: UHC Core |
$1,319.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,184.73
|
|
|
HC CT ORBIT WO CON
|
Facility
|
IP
|
$1,435.44
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$933.04 |
| Max. Negotiated Rate |
$1,291.90 |
| Rate for Payer: Aetna Commercial |
$1,220.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,171.75
|
| Rate for Payer: BCN Commercial |
$1,109.31
|
| Rate for Payer: Cash Price |
$1,148.35
|
| Rate for Payer: Cofinity Commercial |
$1,234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.35
|
| Rate for Payer: Healthscope Commercial |
$1,291.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.12
|
| Rate for Payer: Nomi Health Commercial |
$1,177.06
|
| Rate for Payer: PHP Commercial |
$1,220.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,248.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.19
|
| Rate for Payer: UHC Core |
$1,198.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.58
|
|
|
HC CT ORBIT WO CON
|
Facility
|
OP
|
$1,435.44
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,291.90 |
| Rate for Payer: Aetna Commercial |
$1,220.12
|
| Rate for Payer: Aetna Medicare |
$373.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.58
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$358.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.08
|
| Rate for Payer: BCN Commercial |
$1,116.05
|
| Rate for Payer: BCN Medicare Advantage |
$358.86
|
| Rate for Payer: Cash Price |
$1,148.35
|
| Rate for Payer: Cash Price |
$1,148.35
|
| Rate for Payer: Cofinity Commercial |
$1,234.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.86
|
| Rate for Payer: Healthscope Commercial |
$1,291.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.58
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.80
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.12
|
| Rate for Payer: Nomi Health Commercial |
$1,177.06
|
| Rate for Payer: PACE Senior Care Partners |
$340.92
|
| Rate for Payer: PACE SWMI |
$358.86
|
| Rate for Payer: PHP Commercial |
$1,220.12
|
| Rate for Payer: PHP Medicare Advantage |
$358.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,248.83
|
| Rate for Payer: Priority Health Medicare |
$362.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.74
|
| Rate for Payer: Railroad Medicare Medicare |
$358.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.19
|
| Rate for Payer: UHC Core |
$1,198.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.86
|
| Rate for Payer: UHC Exchange |
$358.86
|
| Rate for Payer: UHC Medicare Advantage |
$358.86
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$358.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.58
|
|
|
HC CT ORBIT WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: Aetna Medicare |
$389.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$468.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$468.34
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$374.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.07
|
| Rate for Payer: BCN Commercial |
$1,165.23
|
| Rate for Payer: BCN Medicare Advantage |
$374.67
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.67
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.02
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.41
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$430.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: PACE Senior Care Partners |
$355.94
|
| Rate for Payer: PACE SWMI |
$374.67
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: PHP Medicare Advantage |
$374.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,303.86
|
| Rate for Payer: Priority Health Medicare |
$378.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,004.12
|
| Rate for Payer: Railroad Medicare Medicare |
$374.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.85
|
| Rate for Payer: UHC Core |
$1,251.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$374.67
|
| Rate for Payer: UHC Exchange |
$374.67
|
| Rate for Payer: UHC Medicare Advantage |
$374.67
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$374.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.02
|
|
|
HC CT ORBIT WO W CON
|
Facility
|
IP
|
$1,498.69
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$974.15 |
| Max. Negotiated Rate |
$1,348.82 |
| Rate for Payer: Aetna Commercial |
$1,273.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,223.38
|
| Rate for Payer: BCN Commercial |
$1,158.19
|
| Rate for Payer: Cash Price |
$1,198.95
|
| Rate for Payer: Cofinity Commercial |
$1,288.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,198.95
|
| Rate for Payer: Healthscope Commercial |
$1,348.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,273.89
|
| Rate for Payer: Nomi Health Commercial |
$1,228.93
|
| Rate for Payer: PHP Commercial |
$1,273.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,303.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,004.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,318.85
|
| Rate for Payer: UHC Core |
$1,251.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.02
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
IP
|
$1,949.22
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,266.99 |
| Max. Negotiated Rate |
$1,754.30 |
| Rate for Payer: Aetna Commercial |
$1,656.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.15
|
| Rate for Payer: BCN Commercial |
$1,506.36
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,676.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.36
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,695.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,305.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,715.31
|
| Rate for Payer: UHC Core |
$1,627.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.92
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
OP
|
$1,949.22
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,754.30 |
| Rate for Payer: Aetna Commercial |
$1,656.84
|
| Rate for Payer: Aetna Medicare |
$506.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$609.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$609.13
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$487.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,602.45
|
| Rate for Payer: BCN Commercial |
$1,515.52
|
| Rate for Payer: BCN Medicare Advantage |
$487.30
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cash Price |
$1,559.38
|
| Rate for Payer: Cofinity Commercial |
$1,676.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.30
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.92
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.67
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$560.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,656.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.36
|
| Rate for Payer: PACE Senior Care Partners |
$462.94
|
| Rate for Payer: PACE SWMI |
$487.30
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: PHP Medicare Advantage |
$487.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,266.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,695.82
|
| Rate for Payer: Priority Health Medicare |
$492.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,305.98
|
| Rate for Payer: Railroad Medicare Medicare |
$487.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,715.31
|
| Rate for Payer: UHC Core |
$1,627.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.30
|
| Rate for Payer: UHC Exchange |
$487.30
|
| Rate for Payer: UHC Medicare Advantage |
$487.30
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$487.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.92
|
|
|
HC CT PELVIS W CON
|
Facility
|
IP
|
$1,936.78
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,258.91 |
| Max. Negotiated Rate |
$1,743.10 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.99
|
| Rate for Payer: BCN Commercial |
$1,496.74
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cofinity Commercial |
$1,665.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.42
|
| Rate for Payer: Healthscope Commercial |
$1,743.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,646.26
|
| Rate for Payer: Nomi Health Commercial |
$1,588.16
|
| Rate for Payer: PHP Commercial |
$1,646.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.91
|
| Rate for Payer: Priority Health HMO/PPO |
$1,685.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,297.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.37
|
| Rate for Payer: UHC Core |
$1,617.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.58
|
|
|
HC CT PELVIS W CON
|
Facility
|
OP
|
$1,936.78
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,743.10 |
| Rate for Payer: Aetna Commercial |
$1,646.26
|
| Rate for Payer: Aetna Medicare |
$503.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$605.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$605.24
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$484.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.23
|
| Rate for Payer: BCN Commercial |
$1,505.85
|
| Rate for Payer: BCN Medicare Advantage |
$484.20
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cash Price |
$1,549.42
|
| Rate for Payer: Cofinity Commercial |
$1,665.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.20
|
| Rate for Payer: Healthscope Commercial |
$1,743.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.58
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.40
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$556.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,646.26
|
| Rate for Payer: Nomi Health Commercial |
$1,588.16
|
| Rate for Payer: PACE Senior Care Partners |
$459.99
|
| Rate for Payer: PACE SWMI |
$484.20
|
| Rate for Payer: PHP Commercial |
$1,646.26
|
| Rate for Payer: PHP Medicare Advantage |
$484.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,258.91
|
| Rate for Payer: Priority Health HMO/PPO |
$1,685.00
|
| Rate for Payer: Priority Health Medicare |
$489.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,297.64
|
| Rate for Payer: Railroad Medicare Medicare |
$484.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.37
|
| Rate for Payer: UHC Core |
$1,617.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.20
|
| Rate for Payer: UHC Exchange |
$484.20
|
| Rate for Payer: UHC Medicare Advantage |
$484.20
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$484.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.58
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,420.15
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$923.10 |
| Max. Negotiated Rate |
$1,278.14 |
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.27
|
| Rate for Payer: BCN Commercial |
$1,097.49
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Healthscope Commercial |
$1,278.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,207.13
|
| Rate for Payer: Nomi Health Commercial |
$1,164.52
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,235.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$951.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,249.73
|
| Rate for Payer: UHC Core |
$1,185.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.11
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,420.15
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,278.14 |
| Rate for Payer: Aetna Commercial |
$1,207.13
|
| Rate for Payer: Aetna Medicare |
$369.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.80
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$355.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.51
|
| Rate for Payer: BCN Commercial |
$1,104.17
|
| Rate for Payer: BCN Medicare Advantage |
$355.04
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cash Price |
$1,136.12
|
| Rate for Payer: Cofinity Commercial |
$1,221.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.04
|
| Rate for Payer: Healthscope Commercial |
$1,278.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.11
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$372.79
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,207.13
|
| Rate for Payer: Nomi Health Commercial |
$1,164.52
|
| Rate for Payer: PACE Senior Care Partners |
$337.29
|
| Rate for Payer: PACE SWMI |
$355.04
|
| Rate for Payer: PHP Commercial |
$1,207.13
|
| Rate for Payer: PHP Medicare Advantage |
$355.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,235.53
|
| Rate for Payer: Priority Health Medicare |
$358.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$951.50
|
| Rate for Payer: Railroad Medicare Medicare |
$355.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,249.73
|
| Rate for Payer: UHC Core |
$1,185.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.04
|
| Rate for Payer: UHC Exchange |
$355.04
|
| Rate for Payer: UHC Medicare Advantage |
$355.04
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$355.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.11
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
IP
|
$2,205.70
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,433.70 |
| Max. Negotiated Rate |
$1,985.13 |
| Rate for Payer: Aetna Commercial |
$1,874.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,800.51
|
| Rate for Payer: BCN Commercial |
$1,704.56
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cofinity Commercial |
$1,896.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.56
|
| Rate for Payer: Healthscope Commercial |
$1,985.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.84
|
| Rate for Payer: Nomi Health Commercial |
$1,808.67
|
| Rate for Payer: PHP Commercial |
$1,874.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,918.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,477.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,941.02
|
| Rate for Payer: UHC Core |
$1,841.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.28
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
OP
|
$2,205.70
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,985.13 |
| Rate for Payer: Aetna Commercial |
$1,874.84
|
| Rate for Payer: Aetna Medicare |
$573.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$689.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$689.28
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$551.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.31
|
| Rate for Payer: BCN Commercial |
$1,714.93
|
| Rate for Payer: BCN Medicare Advantage |
$551.42
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cash Price |
$1,764.56
|
| Rate for Payer: Cofinity Commercial |
$1,896.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.42
|
| Rate for Payer: Healthscope Commercial |
$1,985.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.28
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.00
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.84
|
| Rate for Payer: Nomi Health Commercial |
$1,808.67
|
| Rate for Payer: PACE Senior Care Partners |
$523.85
|
| Rate for Payer: PACE SWMI |
$551.42
|
| Rate for Payer: PHP Commercial |
$1,874.84
|
| Rate for Payer: PHP Medicare Advantage |
$551.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,918.96
|
| Rate for Payer: Priority Health Medicare |
$556.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,477.82
|
| Rate for Payer: Railroad Medicare Medicare |
$551.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,941.02
|
| Rate for Payer: UHC Core |
$1,841.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.42
|
| Rate for Payer: UHC Exchange |
$551.42
|
| Rate for Payer: UHC Medicare Advantage |
$551.42
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$551.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.28
|
|
