|
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 |
$128.71 |
| 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 |
$135.15
|
| 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 |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.66
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| 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 |
$128.71
|
| 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 |
$128.71
|
| 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 |
$76.88 |
| 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 |
$448.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.57
|
| Rate for Payer: BCBS Complete |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.80
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| 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
|
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 ORBIT WO W CON
|
Facility
|
OP
|
$1,498.69
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$128.71 |
| 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 |
$135.15
|
| 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 |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.41
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| 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 |
$128.71
|
| 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 |
$128.71
|
| Rate for Payer: VA VA |
$374.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.02
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
OP
|
$1,949.22
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$128.71 |
| 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 |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$487.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,602.45
|
| Rate for Payer: BCN Commercial |
$1,515.52
|
| Rate for Payer: BCN Medicare Advantage |
$487.31
|
| 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 |
$487.31
|
| Rate for Payer: Healthscope Commercial |
$1,754.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,461.91
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.67
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| 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 |
$487.31
|
| Rate for Payer: PHP Commercial |
$1,656.84
|
| Rate for Payer: PHP Medicare Advantage |
$487.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| 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 |
$487.31
|
| 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 |
$487.31
|
| Rate for Payer: UHC Exchange |
$487.31
|
| Rate for Payer: UHC Medicare Advantage |
$487.31
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$487.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,461.91
|
|
|
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 |
$1,461.91
|
| 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 |
$1,461.91
|
|
|
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 |
$128.71 |
| 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 |
$135.15
|
| Rate for Payer: BCBS MAPPO |
$484.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.23
|
| Rate for Payer: BCN Commercial |
$1,505.85
|
| Rate for Payer: BCN Medicare Advantage |
$484.19
|
| 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 |
$484.19
|
| Rate for Payer: Healthscope Commercial |
$1,743.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.59
|
| Rate for Payer: Mclaren Medicaid |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.40
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| 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 |
$484.19
|
| Rate for Payer: PHP Commercial |
$1,646.26
|
| Rate for Payer: PHP Medicare Advantage |
$484.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| 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 |
$484.19
|
| 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 |
$484.19
|
| Rate for Payer: UHC Exchange |
$484.19
|
| Rate for Payer: UHC Medicare Advantage |
$484.19
|
| Rate for Payer: UHCCP Medicaid |
$128.71
|
| Rate for Payer: VA VA |
$484.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.59
|
|
|
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 |
$1,452.59
|
| 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 |
$1,452.59
|
|
|
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 |
$1,278.13 |
| 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 |
$1,278.13
|
| 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 |
$76.88 |
| Max. Negotiated Rate |
$1,278.13 |
| 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 |
$80.73
|
| 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 |
$1,278.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.11
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$372.79
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| 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 |
$1,874.85
|
| 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 |
$1,874.85
|
| Rate for Payer: Nomi Health Commercial |
$1,808.67
|
| Rate for Payer: PHP Commercial |
$1,874.85
|
| 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 |
$128.71 |
| Max. Negotiated Rate |
$1,985.13 |
| Rate for Payer: Aetna Commercial |
$1,874.85
|
| 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 |
$135.15
|
| 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 |
$128.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$579.00
|
| Rate for Payer: Meridian Medicaid |
$135.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.85
|
| 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 |
$1,874.85
|
| Rate for Payer: PHP Medicare Advantage |
$551.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.71
|
| 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 |
$128.71
|
| Rate for Payer: VA VA |
$551.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.28
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.70 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$255.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.49
|
| Rate for Payer: BCBS Complete |
$469.38
|
| Rate for Payer: BCBS MAPPO |
$246.00
|
| Rate for Payer: BCBS Trust/PPO |
$808.93
|
| Rate for Payer: BCN Commercial |
$765.04
|
| Rate for Payer: BCN Medicare Advantage |
$246.00
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.00
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Mclaren Medicaid |
$447.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Medicaid |
$469.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PACE Senior Care Partners |
$233.70
|
| Rate for Payer: PACE SWMI |
$246.00
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$246.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Medicare |
$248.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: Railroad Medicare Medicare |
$246.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.00
|
| Rate for Payer: UHC Exchange |
$246.00
|
| Rate for Payer: UHC Medicare Advantage |
$246.00
|
| Rate for Payer: UHCCP Medicaid |
$447.00
|
| Rate for Payer: VA VA |
$246.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.59 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.22
|
| Rate for Payer: BCN Commercial |
$760.42
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.59 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.22
|
| Rate for Payer: BCN Commercial |
$760.42
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.70 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$255.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.49
|
| Rate for Payer: BCBS Complete |
$469.38
|
| Rate for Payer: BCBS MAPPO |
$246.00
|
| Rate for Payer: BCBS Trust/PPO |
$808.93
|
| Rate for Payer: BCN Commercial |
$765.04
|
| Rate for Payer: BCN Medicare Advantage |
$246.00
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.00
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Mclaren Medicaid |
$447.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Medicaid |
$469.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PACE Senior Care Partners |
$233.70
|
| Rate for Payer: PACE SWMI |
$246.00
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$246.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Medicare |
$248.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: Railroad Medicare Medicare |
$246.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.00
|
| Rate for Payer: UHC Exchange |
$246.00
|
| Rate for Payer: UHC Medicare Advantage |
$246.00
|
| Rate for Payer: UHCCP Medicaid |
$447.00
|
| Rate for Payer: VA VA |
$246.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$260.44 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$285.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.68
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS MAPPO |
$274.14
|
| Rate for Payer: BCBS Trust/PPO |
$901.50
|
| Rate for Payer: BCN Commercial |
$852.59
|
| Rate for Payer: BCN Medicare Advantage |
$274.14
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.14
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: PACE Senior Care Partners |
$260.44
|
| Rate for Payer: PACE SWMI |
$274.14
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: PHP Medicare Advantage |
$274.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO |
$954.02
|
| Rate for Payer: Priority Health Medicare |
$276.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.71
|
| Rate for Payer: Railroad Medicare Medicare |
$274.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.99
|
| Rate for Payer: UHC Core |
$915.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.14
|
| Rate for Payer: UHC Exchange |
$274.14
|
| Rate for Payer: UHC Medicare Advantage |
$274.14
|
| Rate for Payer: VA VA |
$274.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.43
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$712.78 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: BCBS Trust/PPO |
$895.14
|
| Rate for Payer: BCN Commercial |
$847.44
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO |
$954.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.99
|
| Rate for Payer: UHC Core |
$915.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.43
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.42 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: BCBS Trust/PPO |
$359.69
|
| Rate for Payer: BCN Commercial |
$340.53
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO |
$383.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.76
|
| Rate for Payer: UHC Core |
$367.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$114.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.70
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$110.16
|
| Rate for Payer: BCBS Trust/PPO |
$362.25
|
| Rate for Payer: BCN Commercial |
$342.60
|
| Rate for Payer: BCN Medicare Advantage |
$110.16
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.16
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.67
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: PACE Senior Care Partners |
$104.65
|
| Rate for Payer: PACE SWMI |
$110.16
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: PHP Medicare Advantage |
$110.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO |
$383.36
|
| Rate for Payer: Priority Health Medicare |
$111.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.23
|
| Rate for Payer: Railroad Medicare Medicare |
$110.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.76
|
| Rate for Payer: UHC Core |
$367.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.16
|
| Rate for Payer: UHC Exchange |
$110.16
|
| Rate for Payer: UHC Medicare Advantage |
$110.16
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$110.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.72 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna Commercial |
$507.19
|
| Rate for Payer: Aetna Medicare |
$155.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.47
|
| Rate for Payer: BCBS Complete |
$176.30
|
| Rate for Payer: BCBS MAPPO |
$149.18
|
| Rate for Payer: BCBS Trust/PPO |
$490.55
|
| Rate for Payer: BCN Commercial |
$463.93
|
| Rate for Payer: BCN Medicare Advantage |
$149.18
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.18
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Mclaren Medicaid |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.63
|
| Rate for Payer: Meridian Medicaid |
$176.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.19
|
| Rate for Payer: Nomi Health Commercial |
$489.29
|
| Rate for Payer: PACE Senior Care Partners |
$141.72
|
| Rate for Payer: PACE SWMI |
$149.18
|
| Rate for Payer: PHP Commercial |
$507.19
|
| Rate for Payer: PHP Medicare Advantage |
$149.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health HMO/PPO |
$519.13
|
| Rate for Payer: Priority Health Medicare |
$150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.79
|
| Rate for Payer: Railroad Medicare Medicare |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.10
|
| Rate for Payer: UHC Core |
$498.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.18
|
| Rate for Payer: UHC Exchange |
$149.18
|
| Rate for Payer: UHC Medicare Advantage |
$149.18
|
| Rate for Payer: UHCCP Medicaid |
$167.90
|
| Rate for Payer: VA VA |
$149.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
