|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,770.51
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,133.00 |
| Max. Negotiated Rate |
$4,293.46 |
| Rate for Payer: Aetna Commercial |
$4,054.93
|
| Rate for Payer: Aetna Medicare |
$1,240.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.78
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$1,192.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,709.07
|
| Rate for Payer: BCN Commercial |
$3,709.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.63
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cofinity Commercial |
$4,102.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,816.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.63
|
| Rate for Payer: Healthscope Commercial |
$4,293.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,577.88
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,252.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,054.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,133.00
|
| Rate for Payer: PACE SWMI |
$1,192.63
|
| Rate for Payer: PHP Commercial |
$4,054.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,339.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,150.34
|
| Rate for Payer: Priority Health Medicare |
$1,192.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,909.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,198.05
|
| Rate for Payer: UHC Core |
$3,983.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,192.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,228.41
|
| Rate for Payer: VA VA |
$1,192.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,577.88
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$460.03 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$1,646.43
|
| Rate for Payer: Aetna Medicare |
$503.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$605.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$605.31
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$484.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,506.00
|
| Rate for Payer: BCN Commercial |
$1,506.00
|
| Rate for Payer: BCN Medicare Advantage |
$484.24
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,665.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.24
|
| Rate for Payer: Healthscope Commercial |
$1,743.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.74
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$508.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$556.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: PACE Senior Care Partners |
$460.03
|
| Rate for Payer: PACE SWMI |
$484.24
|
| Rate for Payer: PHP Commercial |
$1,646.43
|
| Rate for Payer: PHP Medicare Advantage |
$484.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,685.17
|
| Rate for Payer: Priority Health Medicare |
$484.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,181.36
|
| Rate for Payer: Railroad Medicare Medicare |
$484.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.54
|
| Rate for Payer: UHC Core |
$1,617.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.24
|
| Rate for Payer: UHC Medicare Advantage |
$498.77
|
| Rate for Payer: VA VA |
$484.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.74
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,181.36 |
| Max. Negotiated Rate |
$1,743.28 |
| Rate for Payer: Aetna Commercial |
$1,646.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.90
|
| Rate for Payer: BCN Commercial |
$1,496.90
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,665.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Healthscope Commercial |
$1,743.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: PHP Commercial |
$1,646.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,685.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,704.54
|
| Rate for Payer: UHC Core |
$1,617.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.74
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,547.12 |
| Max. Negotiated Rate |
$2,283.01 |
| Rate for Payer: Aetna Commercial |
$2,156.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.35
|
| Rate for Payer: BCN Commercial |
$1,960.35
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$2,181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Healthscope Commercial |
$2,283.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,902.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,156.18
|
| Rate for Payer: PHP Commercial |
$2,156.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,206.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,547.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,232.28
|
| Rate for Payer: UHC Core |
$2,118.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,902.51
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$602.46 |
| Max. Negotiated Rate |
$2,283.01 |
| Rate for Payer: Aetna Commercial |
$2,156.18
|
| Rate for Payer: Aetna Medicare |
$659.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$792.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$792.71
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$634.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,972.27
|
| Rate for Payer: BCN Commercial |
$1,972.27
|
| Rate for Payer: BCN Medicare Advantage |
$634.17
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$2,181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$634.17
|
| Rate for Payer: Healthscope Commercial |
$2,283.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,902.51
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$729.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,156.18
|
| Rate for Payer: PACE Senior Care Partners |
$602.46
|
| Rate for Payer: PACE SWMI |
$634.17
|
| Rate for Payer: PHP Commercial |
$2,156.18
|
| Rate for Payer: PHP Medicare Advantage |
$634.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,206.91
|
| Rate for Payer: Priority Health Medicare |
$634.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,547.12
|
| Rate for Payer: Railroad Medicare Medicare |
$634.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,232.28
|
| Rate for Payer: UHC Core |
$2,118.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$634.17
|
| Rate for Payer: UHC Medicare Advantage |
$653.20
|
| Rate for Payer: VA VA |
$634.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,902.51
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$308.57 |
| Max. Negotiated Rate |
$1,169.32 |
| Rate for Payer: Aetna Commercial |
$1,104.36
|
| Rate for Payer: Aetna Medicare |
$337.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.02
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$324.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.17
|
| Rate for Payer: BCN Commercial |
$1,010.17
|
| Rate for Payer: BCN Medicare Advantage |
$324.81
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.81
|
| Rate for Payer: Healthscope Commercial |
$1,169.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.44
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: PACE Senior Care Partners |
$308.57
|
| Rate for Payer: PACE SWMI |
$324.81
|
| Rate for Payer: PHP Commercial |
$1,104.36
|
| Rate for Payer: PHP Medicare Advantage |
$324.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.35
|
| Rate for Payer: Priority Health Medicare |
$324.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$792.41
|
| Rate for Payer: Railroad Medicare Medicare |
$324.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,143.34
|
| Rate for Payer: UHC Core |
$1,084.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.81
|
| Rate for Payer: UHC Medicare Advantage |
$334.56
|
| Rate for Payer: VA VA |
$324.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.44
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$792.41 |
| Max. Negotiated Rate |
$1,169.32 |
| Rate for Payer: Aetna Commercial |
$1,104.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.06
|
| Rate for Payer: BCN Commercial |
$1,004.06
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,117.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Healthscope Commercial |
$1,169.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: PHP Commercial |
$1,104.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$792.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,143.34
|
| Rate for Payer: UHC Core |
$1,084.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.44
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.97 |
| Max. Negotiated Rate |
$863.22 |
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: BCBS Trust/PPO |
$741.22
|
| Rate for Payer: BCN Commercial |
$741.22
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$584.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$844.03
|
| Rate for Payer: UHC Core |
$800.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.79 |
| Max. Negotiated Rate |
$863.22 |
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: Aetna Medicare |
$249.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$299.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$299.73
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$239.78
|
| Rate for Payer: BCBS Trust/PPO |
$745.72
|
| Rate for Payer: BCN Commercial |
$745.72
|
| Rate for Payer: BCN Medicare Advantage |
$239.78
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.78
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: PACE Senior Care Partners |
$227.79
|
| Rate for Payer: PACE SWMI |
$239.78
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: PHP Medicare Advantage |
$239.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.44
|
| Rate for Payer: Priority Health Medicare |
$239.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$584.97
|
| Rate for Payer: Railroad Medicare Medicare |
$239.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$844.03
|
| Rate for Payer: UHC Core |
$800.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.78
|
| Rate for Payer: UHC Medicare Advantage |
$246.98
|
| Rate for Payer: VA VA |
$239.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,810.68 |
| Max. Negotiated Rate |
$2,671.93 |
| Rate for Payer: Aetna Commercial |
$2,523.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.30
|
| Rate for Payer: BCN Commercial |
$2,294.30
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,553.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Healthscope Commercial |
$2,671.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,226.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,523.49
|
| Rate for Payer: PHP Commercial |
$2,523.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,582.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,612.55
|
| Rate for Payer: UHC Core |
$2,478.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,226.61
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$705.09 |
| Max. Negotiated Rate |
$2,671.93 |
| Rate for Payer: Aetna Commercial |
$2,523.49
|
| Rate for Payer: Aetna Medicare |
$771.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$927.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$927.75
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$742.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.25
|
| Rate for Payer: BCN Commercial |
$2,308.25
|
| Rate for Payer: BCN Medicare Advantage |
$742.20
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,553.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$742.20
|
| Rate for Payer: Healthscope Commercial |
$2,671.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,226.61
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$779.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$853.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,523.49
|
| Rate for Payer: PACE Senior Care Partners |
$705.09
|
| Rate for Payer: PACE SWMI |
$742.20
|
| Rate for Payer: PHP Commercial |
$2,523.49
|
| Rate for Payer: PHP Medicare Advantage |
$742.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,582.86
|
| Rate for Payer: Priority Health Medicare |
$742.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.68
|
| Rate for Payer: Railroad Medicare Medicare |
$742.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,612.55
|
| Rate for Payer: UHC Core |
$2,478.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$742.20
|
| Rate for Payer: UHC Medicare Advantage |
$764.47
|
| Rate for Payer: VA VA |
$742.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,226.61
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,274.12
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$777.09 |
| Max. Negotiated Rate |
$1,146.71 |
| Rate for Payer: Aetna Commercial |
$1,083.00
|
| Rate for Payer: BCBS Trust/PPO |
$984.64
|
| Rate for Payer: BCN Commercial |
$984.64
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cofinity Commercial |
$1,095.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,019.30
|
| Rate for Payer: Healthscope Commercial |
$1,146.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$955.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.00
|
| Rate for Payer: PHP Commercial |
$1,083.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,108.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.23
|
| Rate for Payer: UHC Core |
$1,063.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$955.59
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,274.12
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$302.60 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$1,083.00
|
| Rate for Payer: Aetna Medicare |
$331.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.16
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$318.53
|
| Rate for Payer: BCBS Trust/PPO |
$990.63
|
| Rate for Payer: BCN Commercial |
$990.63
|
| Rate for Payer: BCN Medicare Advantage |
$318.53
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cash Price |
$1,019.30
|
| Rate for Payer: Cofinity Commercial |
$1,095.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,019.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.53
|
| Rate for Payer: Healthscope Commercial |
$1,146.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$955.59
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.00
|
| Rate for Payer: PACE Senior Care Partners |
$302.60
|
| Rate for Payer: PACE SWMI |
$318.53
|
| Rate for Payer: PHP Commercial |
$1,083.00
|
| Rate for Payer: PHP Medicare Advantage |
$318.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,108.48
|
| Rate for Payer: Priority Health Medicare |
$318.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.09
|
| Rate for Payer: Railroad Medicare Medicare |
$318.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.23
|
| Rate for Payer: UHC Core |
$1,063.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.53
|
| Rate for Payer: UHC Medicare Advantage |
$328.09
|
| Rate for Payer: VA VA |
$318.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$955.59
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$135.81 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$148.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.70
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$142.96
|
| Rate for Payer: BCBS Trust/PPO |
$444.61
|
| Rate for Payer: BCN Commercial |
$444.61
|
| Rate for Payer: BCN Medicare Advantage |
$142.96
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.96
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Mclaren Medicaid |
$284.77
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Senior Care Partners |
$135.81
|
| Rate for Payer: PACE SWMI |
$142.96
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$142.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Medicare |
$142.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: Railroad Medicare Medicare |
$142.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.96
|
| Rate for Payer: UHC Medicare Advantage |
$147.25
|
| Rate for Payer: VA VA |
$142.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: BCBS Trust/PPO |
$441.92
|
| Rate for Payer: BCN Commercial |
$441.92
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,602.41
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,197.11 |
| Max. Negotiated Rate |
$3,242.17 |
| Rate for Payer: Aetna Commercial |
$3,062.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,783.94
|
| Rate for Payer: BCN Commercial |
$2,783.94
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cofinity Commercial |
$3,098.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,881.93
|
| Rate for Payer: Healthscope Commercial |
$3,242.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,701.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,062.05
|
| Rate for Payer: PHP Commercial |
$3,062.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,134.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,197.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,170.12
|
| Rate for Payer: UHC Core |
$3,008.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,701.81
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,602.41
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$855.57 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$3,062.05
|
| Rate for Payer: Aetna Medicare |
$936.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,125.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,125.75
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$900.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,800.87
|
| Rate for Payer: BCN Commercial |
$2,800.87
|
| Rate for Payer: BCN Medicare Advantage |
$900.60
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cash Price |
$2,881.93
|
| Rate for Payer: Cofinity Commercial |
$3,098.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,881.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.60
|
| Rate for Payer: Healthscope Commercial |
$3,242.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,701.81
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$945.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,062.05
|
| Rate for Payer: PACE Senior Care Partners |
$855.57
|
| Rate for Payer: PACE SWMI |
$900.60
|
| Rate for Payer: PHP Commercial |
$3,062.05
|
| Rate for Payer: PHP Medicare Advantage |
$900.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,134.10
|
| Rate for Payer: Priority Health Medicare |
$900.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,197.11
|
| Rate for Payer: Railroad Medicare Medicare |
$900.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,170.12
|
| Rate for Payer: UHC Core |
$3,008.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.60
|
| Rate for Payer: UHC Medicare Advantage |
$927.62
|
| Rate for Payer: VA VA |
$900.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,701.81
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$900.70
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$549.34 |
| Max. Negotiated Rate |
$810.63 |
| Rate for Payer: Aetna Commercial |
$765.60
|
| Rate for Payer: BCBS Trust/PPO |
$696.06
|
| Rate for Payer: BCN Commercial |
$696.06
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$774.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Healthscope Commercial |
$810.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: PHP Commercial |
$765.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.62
|
| Rate for Payer: UHC Core |
$752.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.52
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$900.70
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.92 |
| Max. Negotiated Rate |
$810.63 |
| Rate for Payer: Aetna Commercial |
$765.60
|
| Rate for Payer: Aetna Medicare |
$234.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.47
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$225.18
|
| Rate for Payer: BCBS Trust/PPO |
$700.29
|
| Rate for Payer: BCN Commercial |
$700.29
|
| Rate for Payer: BCN Medicare Advantage |
$225.18
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cash Price |
$720.56
|
| Rate for Payer: Cofinity Commercial |
$774.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.18
|
| Rate for Payer: Healthscope Commercial |
$810.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.52
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.60
|
| Rate for Payer: PACE Senior Care Partners |
$213.92
|
| Rate for Payer: PACE SWMI |
$225.18
|
| Rate for Payer: PHP Commercial |
$765.60
|
| Rate for Payer: PHP Medicare Advantage |
$225.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.61
|
| Rate for Payer: Priority Health Medicare |
$225.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.34
|
| Rate for Payer: Railroad Medicare Medicare |
$225.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.62
|
| Rate for Payer: UHC Core |
$752.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.18
|
| Rate for Payer: UHC Medicare Advantage |
$231.93
|
| Rate for Payer: VA VA |
$225.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.52
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$993.28
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$235.90 |
| Max. Negotiated Rate |
$893.95 |
| Rate for Payer: Aetna Commercial |
$844.29
|
| Rate for Payer: Aetna Medicare |
$258.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.40
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$248.32
|
| Rate for Payer: BCBS Trust/PPO |
$772.28
|
| Rate for Payer: BCN Commercial |
$772.28
|
| Rate for Payer: BCN Medicare Advantage |
$248.32
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cofinity Commercial |
$854.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.32
|
| Rate for Payer: Healthscope Commercial |
$893.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$744.96
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$844.29
|
| Rate for Payer: PACE Senior Care Partners |
$235.90
|
| Rate for Payer: PACE SWMI |
$248.32
|
| Rate for Payer: PHP Commercial |
$844.29
|
| Rate for Payer: PHP Medicare Advantage |
$248.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$864.15
|
| Rate for Payer: Priority Health Medicare |
$248.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.80
|
| Rate for Payer: Railroad Medicare Medicare |
$248.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.09
|
| Rate for Payer: UHC Core |
$829.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.32
|
| Rate for Payer: UHC Medicare Advantage |
$255.77
|
| Rate for Payer: VA VA |
$248.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$744.96
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$993.28
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$605.80 |
| Max. Negotiated Rate |
$893.95 |
| Rate for Payer: Aetna Commercial |
$844.29
|
| Rate for Payer: BCBS Trust/PPO |
$767.61
|
| Rate for Payer: BCN Commercial |
$767.61
|
| Rate for Payer: Cash Price |
$794.62
|
| Rate for Payer: Cofinity Commercial |
$854.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.62
|
| Rate for Payer: Healthscope Commercial |
$893.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$744.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$844.29
|
| Rate for Payer: PHP Commercial |
$844.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$864.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.09
|
| Rate for Payer: UHC Core |
$829.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$744.96
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,334.17
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$813.71 |
| Max. Negotiated Rate |
$1,200.75 |
| Rate for Payer: Aetna Commercial |
$1,134.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,031.05
|
| Rate for Payer: BCN Commercial |
$1,031.05
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cofinity Commercial |
$1,147.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.34
|
| Rate for Payer: Healthscope Commercial |
$1,200.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.04
|
| Rate for Payer: PHP Commercial |
$1,134.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.07
|
| Rate for Payer: UHC Core |
$1,114.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.63
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,334.17
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$316.87 |
| Max. Negotiated Rate |
$1,200.75 |
| Rate for Payer: Aetna Commercial |
$1,134.04
|
| Rate for Payer: Aetna Medicare |
$346.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.93
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$333.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.32
|
| Rate for Payer: BCN Commercial |
$1,037.32
|
| Rate for Payer: BCN Medicare Advantage |
$333.54
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cash Price |
$1,067.34
|
| Rate for Payer: Cofinity Commercial |
$1,147.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.54
|
| Rate for Payer: Healthscope Commercial |
$1,200.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.63
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$350.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.04
|
| Rate for Payer: PACE Senior Care Partners |
$316.87
|
| Rate for Payer: PACE SWMI |
$333.54
|
| Rate for Payer: PHP Commercial |
$1,134.04
|
| Rate for Payer: PHP Medicare Advantage |
$333.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,160.73
|
| Rate for Payer: Priority Health Medicare |
$333.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.71
|
| Rate for Payer: Railroad Medicare Medicare |
$333.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.07
|
| Rate for Payer: UHC Core |
$1,114.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.54
|
| Rate for Payer: UHC Medicare Advantage |
$343.55
|
| Rate for Payer: VA VA |
$333.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.63
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$45.03
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$40.53 |
| Rate for Payer: Aetna Commercial |
$38.28
|
| Rate for Payer: Aetna Medicare |
$11.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.07
|
| Rate for Payer: BCBS Complete |
$6.77
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCBS Trust/PPO |
$35.01
|
| Rate for Payer: BCN Commercial |
$35.01
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$38.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.77
|
| Rate for Payer: Mclaren Medicaid |
$6.45
|
| Rate for Payer: Meridian Medicaid |
$6.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: PACE Senior Care Partners |
$10.69
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$38.28
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.18
|
| Rate for Payer: Priority Health Medicare |
$11.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.46
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.63
|
| Rate for Payer: UHC Core |
$37.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.26
|
| Rate for Payer: UHC Medicare Advantage |
$11.60
|
| Rate for Payer: VA VA |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.77
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.03
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$40.53 |
| Rate for Payer: Aetna Commercial |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$34.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$38.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Healthscope Commercial |
$40.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: PHP Commercial |
$38.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.63
|
| Rate for Payer: UHC Core |
$37.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.77
|
|
