|
HC IONTOPHORESIS EACH 15 MIN
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$63.45 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$80.40
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
OP
|
$950.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$225.62 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$807.50
|
| Rate for Payer: Aetna Medicare |
$247.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.88
|
| Rate for Payer: BCBS Complete |
$380.00
|
| Rate for Payer: BCBS MAPPO |
$237.50
|
| Rate for Payer: BCBS Trust/PPO |
$738.62
|
| Rate for Payer: BCN Commercial |
$738.62
|
| Rate for Payer: BCN Medicare Advantage |
$237.50
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$817.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.50
|
| Rate for Payer: Healthscope Commercial |
$855.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$807.50
|
| Rate for Payer: PACE Senior Care Partners |
$225.62
|
| Rate for Payer: PACE SWMI |
$237.50
|
| Rate for Payer: PHP Commercial |
$807.50
|
| Rate for Payer: PHP Medicare Advantage |
$237.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$826.50
|
| Rate for Payer: Priority Health Medicare |
$237.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.40
|
| Rate for Payer: Railroad Medicare Medicare |
$237.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.00
|
| Rate for Payer: UHC Core |
$793.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.50
|
| Rate for Payer: UHC Medicare Advantage |
$244.62
|
| Rate for Payer: VA VA |
$237.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.50
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
IP
|
$950.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$579.40 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Aetna Commercial |
$807.50
|
| Rate for Payer: BCBS Trust/PPO |
$734.16
|
| Rate for Payer: BCN Commercial |
$734.16
|
| Rate for Payer: Cash Price |
$760.00
|
| Rate for Payer: Cofinity Commercial |
$817.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.00
|
| Rate for Payer: Healthscope Commercial |
$855.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$807.50
|
| Rate for Payer: PHP Commercial |
$807.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$826.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.00
|
| Rate for Payer: UHC Core |
$793.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.50
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$590.99 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: BCBS Trust/PPO |
$748.84
|
| Rate for Payer: BCN Commercial |
$748.84
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$843.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$590.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$230.14 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$251.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.81
|
| Rate for Payer: BCBS Complete |
$481.33
|
| Rate for Payer: BCBS MAPPO |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$753.40
|
| Rate for Payer: BCN Commercial |
$753.40
|
| Rate for Payer: BCN Medicare Advantage |
$242.25
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.25
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Mclaren Medicaid |
$458.41
|
| Rate for Payer: Meridian Medicaid |
$481.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$823.65
|
| Rate for Payer: PACE Senior Care Partners |
$230.14
|
| Rate for Payer: PACE SWMI |
$242.25
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$242.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$678.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$843.03
|
| Rate for Payer: Priority Health Medicare |
$242.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$590.99
|
| Rate for Payer: Railroad Medicare Medicare |
$242.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.25
|
| Rate for Payer: UHC Medicare Advantage |
$249.52
|
| Rate for Payer: VA VA |
$242.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
OP
|
$135.92
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$32.28 |
| Max. Negotiated Rate |
$146.91 |
| Rate for Payer: Aetna Commercial |
$115.53
|
| Rate for Payer: Aetna Medicare |
$35.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.48
|
| Rate for Payer: BCBS Complete |
$146.91
|
| Rate for Payer: BCBS MAPPO |
$33.98
|
| Rate for Payer: BCBS Trust/PPO |
$105.68
|
| Rate for Payer: BCN Commercial |
$105.68
|
| Rate for Payer: BCN Medicare Advantage |
$33.98
|
| Rate for Payer: Cash Price |
$108.74
|
| Rate for Payer: Cash Price |
$108.74
|
| Rate for Payer: Cofinity Commercial |
$116.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.98
|
| Rate for Payer: Healthscope Commercial |
$122.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.94
|
| Rate for Payer: Mclaren Medicaid |
$139.92
|
| Rate for Payer: Meridian Medicaid |
$146.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.53
|
| Rate for Payer: PACE Senior Care Partners |
$32.28
|
| Rate for Payer: PACE SWMI |
$33.98
|
| Rate for Payer: PHP Commercial |
$115.53
|
| Rate for Payer: PHP Medicare Advantage |
$33.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.25
|
| Rate for Payer: Priority Health Medicare |
$33.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.90
|
| Rate for Payer: Railroad Medicare Medicare |
$33.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.61
|
| Rate for Payer: UHC Core |
$113.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.98
|
| Rate for Payer: UHC Medicare Advantage |
$35.00
|
| Rate for Payer: VA VA |
$33.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.94
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
IP
|
$135.92
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$82.90 |
| Max. Negotiated Rate |
$122.33 |
| Rate for Payer: Aetna Commercial |
$115.53
|
| Rate for Payer: BCBS Trust/PPO |
$105.04
|
| Rate for Payer: BCN Commercial |
$105.04
|
| Rate for Payer: Cash Price |
$108.74
|
| Rate for Payer: Cofinity Commercial |
$116.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.74
|
| Rate for Payer: Healthscope Commercial |
$122.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.53
|
| Rate for Payer: PHP Commercial |
$115.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.61
|
| Rate for Payer: UHC Core |
$113.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.94
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
IP
|
$4.08
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.49 |
| Max. Negotiated Rate |
$3.67 |
| Rate for Payer: Aetna Commercial |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$3.15
|
| Rate for Payer: BCN Commercial |
$3.15
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Cofinity Commercial |
$3.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.26
|
| Rate for Payer: Healthscope Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.47
|
| Rate for Payer: PHP Commercial |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Core |
$3.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.06
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
OP
|
$4.08
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$3.67 |
| Rate for Payer: Aetna Commercial |
$3.47
|
| Rate for Payer: Aetna Medicare |
$1.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.28
|
| Rate for Payer: BCBS Complete |
$1.63
|
| Rate for Payer: BCBS MAPPO |
$1.02
|
| Rate for Payer: BCBS Trust/PPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$1.02
|
| Rate for Payer: Cash Price |
$3.26
|
| Rate for Payer: Cofinity Commercial |
$3.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.02
|
| Rate for Payer: Healthscope Commercial |
$3.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.47
|
| Rate for Payer: PACE Senior Care Partners |
$0.97
|
| Rate for Payer: PACE SWMI |
$1.02
|
| Rate for Payer: PHP Commercial |
$3.47
|
| Rate for Payer: PHP Medicare Advantage |
$1.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.55
|
| Rate for Payer: Priority Health Medicare |
$1.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Core |
$3.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.02
|
| Rate for Payer: UHC Medicare Advantage |
$1.05
|
| Rate for Payer: VA VA |
$1.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.06
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
IP
|
$860.90
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$525.06 |
| Max. Negotiated Rate |
$774.81 |
| Rate for Payer: Aetna Commercial |
$731.76
|
| Rate for Payer: BCBS Trust/PPO |
$665.30
|
| Rate for Payer: BCN Commercial |
$665.30
|
| Rate for Payer: Cash Price |
$688.72
|
| Rate for Payer: Cofinity Commercial |
$740.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.72
|
| Rate for Payer: Healthscope Commercial |
$774.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$731.76
|
| Rate for Payer: PHP Commercial |
$731.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$525.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.59
|
| Rate for Payer: UHC Core |
$718.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.68
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
OP
|
$860.90
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$204.46 |
| Max. Negotiated Rate |
$774.81 |
| Rate for Payer: Aetna Commercial |
$731.76
|
| Rate for Payer: Aetna Medicare |
$223.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.03
|
| Rate for Payer: BCBS Complete |
$344.36
|
| Rate for Payer: BCBS MAPPO |
$215.22
|
| Rate for Payer: BCBS Trust/PPO |
$669.35
|
| Rate for Payer: BCN Commercial |
$669.35
|
| Rate for Payer: BCN Medicare Advantage |
$215.22
|
| Rate for Payer: Cash Price |
$688.72
|
| Rate for Payer: Cofinity Commercial |
$740.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.22
|
| Rate for Payer: Healthscope Commercial |
$774.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$731.76
|
| Rate for Payer: PACE Senior Care Partners |
$204.46
|
| Rate for Payer: PACE SWMI |
$215.22
|
| Rate for Payer: PHP Commercial |
$731.76
|
| Rate for Payer: PHP Medicare Advantage |
$215.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.98
|
| Rate for Payer: Priority Health Medicare |
$215.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$525.06
|
| Rate for Payer: Railroad Medicare Medicare |
$215.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.59
|
| Rate for Payer: UHC Core |
$718.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.22
|
| Rate for Payer: UHC Medicare Advantage |
$221.68
|
| Rate for Payer: VA VA |
$215.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.68
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$379.99 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,683.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,026.58 |
| Max. Negotiated Rate |
$1,514.88 |
| Rate for Payer: Aetna Commercial |
$1,430.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.78
|
| Rate for Payer: BCN Commercial |
$1,300.78
|
| Rate for Payer: Cash Price |
$1,346.56
|
| Rate for Payer: Cofinity Commercial |
$1,447.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.56
|
| Rate for Payer: Healthscope Commercial |
$1,514.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.72
|
| Rate for Payer: PHP Commercial |
$1,430.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,464.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,481.22
|
| Rate for Payer: UHC Core |
$1,405.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.40
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
OP
|
$1,683.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$399.76 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$1,430.72
|
| Rate for Payer: Aetna Medicare |
$437.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$526.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$526.00
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$420.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.69
|
| Rate for Payer: BCN Commercial |
$1,308.69
|
| Rate for Payer: BCN Medicare Advantage |
$420.80
|
| Rate for Payer: Cash Price |
$1,346.56
|
| Rate for Payer: Cash Price |
$1,346.56
|
| Rate for Payer: Cofinity Commercial |
$1,447.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.80
|
| Rate for Payer: Healthscope Commercial |
$1,514.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.40
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$441.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$483.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.72
|
| Rate for Payer: PACE Senior Care Partners |
$399.76
|
| Rate for Payer: PACE SWMI |
$420.80
|
| Rate for Payer: PHP Commercial |
$1,430.72
|
| Rate for Payer: PHP Medicare Advantage |
$420.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,464.38
|
| Rate for Payer: Priority Health Medicare |
$420.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.58
|
| Rate for Payer: Railroad Medicare Medicare |
$420.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,481.22
|
| Rate for Payer: UHC Core |
$1,405.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.80
|
| Rate for Payer: UHC Medicare Advantage |
$433.42
|
| Rate for Payer: VA VA |
$420.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.40
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
IP
|
$3,202.09
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,952.95 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,474.58
|
| Rate for Payer: BCN Commercial |
$2,474.58
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,785.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,952.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,817.84
|
| Rate for Payer: UHC Core |
$2,673.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
OP
|
$3,202.09
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna Medicare |
$832.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.65
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$800.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.62
|
| Rate for Payer: BCN Commercial |
$2,489.62
|
| Rate for Payer: BCN Medicare Advantage |
$800.52
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.52
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$840.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PACE Senior Care Partners |
$760.50
|
| Rate for Payer: PACE SWMI |
$800.52
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: PHP Medicare Advantage |
$800.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,785.82
|
| Rate for Payer: Priority Health Medicare |
$800.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,952.95
|
| Rate for Payer: Railroad Medicare Medicare |
$800.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,817.84
|
| Rate for Payer: UHC Core |
$2,673.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.52
|
| Rate for Payer: UHC Medicare Advantage |
$824.54
|
| Rate for Payer: VA VA |
$800.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,389.80
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,067.44 |
| Max. Negotiated Rate |
$3,050.82 |
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,619.64
|
| Rate for Payer: BCN Commercial |
$2,619.64
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,949.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,983.02
|
| Rate for Payer: UHC Core |
$2,830.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$3,389.80
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$805.08 |
| Max. Negotiated Rate |
$3,050.82 |
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: Aetna Medicare |
$881.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,059.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,059.31
|
| Rate for Payer: BCBS Complete |
$1,355.92
|
| Rate for Payer: BCBS MAPPO |
$847.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.57
|
| Rate for Payer: BCN Commercial |
$2,635.57
|
| Rate for Payer: BCN Medicare Advantage |
$847.45
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$847.45
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$889.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$974.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PACE Senior Care Partners |
$805.08
|
| Rate for Payer: PACE SWMI |
$847.45
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: PHP Medicare Advantage |
$847.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,949.13
|
| Rate for Payer: Priority Health Medicare |
$847.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.44
|
| Rate for Payer: Railroad Medicare Medicare |
$847.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,983.02
|
| Rate for Payer: UHC Core |
$2,830.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$847.45
|
| Rate for Payer: UHC Medicare Advantage |
$872.87
|
| Rate for Payer: VA VA |
$847.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$9,660.92
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,294.47 |
| Max. Negotiated Rate |
$8,694.83 |
| Rate for Payer: Aetna Commercial |
$8,211.78
|
| Rate for Payer: Aetna Medicare |
$2,511.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,019.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,019.04
|
| Rate for Payer: BCBS Complete |
$3,864.37
|
| Rate for Payer: BCBS MAPPO |
$2,415.23
|
| Rate for Payer: BCBS Trust/PPO |
$7,511.37
|
| Rate for Payer: BCN Commercial |
$7,511.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,415.23
|
| Rate for Payer: Cash Price |
$7,728.74
|
| Rate for Payer: Cofinity Commercial |
$8,308.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,415.23
|
| Rate for Payer: Healthscope Commercial |
$8,694.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,245.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,535.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,777.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.78
|
| Rate for Payer: PACE Senior Care Partners |
$2,294.47
|
| Rate for Payer: PACE SWMI |
$2,415.23
|
| Rate for Payer: PHP Commercial |
$8,211.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,415.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,405.00
|
| Rate for Payer: Priority Health Medicare |
$2,415.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,892.20
|
| Rate for Payer: Railroad Medicare Medicare |
$2,415.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,501.61
|
| Rate for Payer: UHC Core |
$8,066.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,415.23
|
| Rate for Payer: UHC Medicare Advantage |
$2,487.69
|
| Rate for Payer: VA VA |
$2,415.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,245.69
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$9,660.92
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,892.20 |
| Max. Negotiated Rate |
$8,694.83 |
| Rate for Payer: Aetna Commercial |
$8,211.78
|
| Rate for Payer: BCBS Trust/PPO |
$7,465.96
|
| Rate for Payer: BCN Commercial |
$7,465.96
|
| Rate for Payer: Cash Price |
$7,728.74
|
| Rate for Payer: Cofinity Commercial |
$8,308.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.74
|
| Rate for Payer: Healthscope Commercial |
$8,694.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,245.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.78
|
| Rate for Payer: PHP Commercial |
$8,211.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,405.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,892.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,501.61
|
| Rate for Payer: UHC Core |
$8,066.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,245.69
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
OP
|
$3,402.31
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$808.05 |
| Max. Negotiated Rate |
$3,062.08 |
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: Aetna Medicare |
$884.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,063.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,063.22
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$850.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,645.30
|
| Rate for Payer: BCN Commercial |
$2,645.30
|
| Rate for Payer: BCN Medicare Advantage |
$850.58
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$850.58
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,551.73
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$893.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$978.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PACE Senior Care Partners |
$808.05
|
| Rate for Payer: PACE SWMI |
$850.58
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: PHP Medicare Advantage |
$850.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,960.01
|
| Rate for Payer: Priority Health Medicare |
$850.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,075.07
|
| Rate for Payer: Railroad Medicare Medicare |
$850.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,994.03
|
| Rate for Payer: UHC Core |
$2,840.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$850.58
|
| Rate for Payer: UHC Medicare Advantage |
$876.09
|
| Rate for Payer: VA VA |
$850.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,551.73
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
IP
|
$3,402.31
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,075.07 |
| Max. Negotiated Rate |
$3,062.08 |
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,629.31
|
| Rate for Payer: BCN Commercial |
$2,629.31
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,551.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,960.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,075.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,994.03
|
| Rate for Payer: UHC Core |
$2,840.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,551.73
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
OP
|
$4,035.36
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$958.40 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$3,430.06
|
| Rate for Payer: Aetna Medicare |
$1,049.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,261.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,261.05
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$1,008.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.49
|
| Rate for Payer: BCN Commercial |
$3,137.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,008.84
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cofinity Commercial |
$3,470.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,228.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,008.84
|
| Rate for Payer: Healthscope Commercial |
$3,631.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,026.52
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,059.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,160.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,430.06
|
| Rate for Payer: PACE Senior Care Partners |
$958.40
|
| Rate for Payer: PACE SWMI |
$1,008.84
|
| Rate for Payer: PHP Commercial |
$3,430.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,008.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,824.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,510.76
|
| Rate for Payer: Priority Health Medicare |
$1,008.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,008.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,551.12
|
| Rate for Payer: UHC Core |
$3,369.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,008.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,039.11
|
| Rate for Payer: VA VA |
$1,008.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,026.52
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
IP
|
$4,035.36
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,461.17 |
| Max. Negotiated Rate |
$3,631.82 |
| Rate for Payer: Aetna Commercial |
$3,430.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,118.53
|
| Rate for Payer: BCN Commercial |
$3,118.53
|
| Rate for Payer: Cash Price |
$3,228.29
|
| Rate for Payer: Cofinity Commercial |
$3,470.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,228.29
|
| Rate for Payer: Healthscope Commercial |
$3,631.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,026.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,430.06
|
| Rate for Payer: PHP Commercial |
$3,430.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,824.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,510.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,551.12
|
| Rate for Payer: UHC Core |
$3,369.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,026.52
|
|
