|
HC IRON LEVEL
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$564.95
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$344.56 |
| Max. Negotiated Rate |
$508.46 |
| Rate for Payer: Aetna Commercial |
$480.21
|
| Rate for Payer: BCBS Trust/PPO |
$436.59
|
| Rate for Payer: BCN Commercial |
$436.59
|
| Rate for Payer: Cash Price |
$451.96
|
| Rate for Payer: Cofinity Commercial |
$485.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.96
|
| Rate for Payer: Healthscope Commercial |
$508.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.21
|
| Rate for Payer: PHP Commercial |
$480.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.16
|
| Rate for Payer: UHC Core |
$471.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.71
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$564.95
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.18 |
| Max. Negotiated Rate |
$508.46 |
| Rate for Payer: Aetna Commercial |
$480.21
|
| Rate for Payer: Aetna Medicare |
$146.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.55
|
| Rate for Payer: BCBS Complete |
$225.98
|
| Rate for Payer: BCBS MAPPO |
$141.24
|
| Rate for Payer: BCBS Trust/PPO |
$439.25
|
| Rate for Payer: BCN Commercial |
$439.25
|
| Rate for Payer: BCN Medicare Advantage |
$141.24
|
| Rate for Payer: Cash Price |
$451.96
|
| Rate for Payer: Cofinity Commercial |
$485.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.24
|
| Rate for Payer: Healthscope Commercial |
$508.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.21
|
| Rate for Payer: PACE Senior Care Partners |
$134.18
|
| Rate for Payer: PACE SWMI |
$141.24
|
| Rate for Payer: PHP Commercial |
$480.21
|
| Rate for Payer: PHP Medicare Advantage |
$141.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.51
|
| Rate for Payer: Priority Health Medicare |
$141.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.56
|
| Rate for Payer: Railroad Medicare Medicare |
$141.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.16
|
| Rate for Payer: UHC Core |
$471.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.24
|
| Rate for Payer: UHC Medicare Advantage |
$145.47
|
| Rate for Payer: VA VA |
$141.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.71
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,409.19
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,958.46 |
| Max. Negotiated Rate |
$10,268.27 |
| Rate for Payer: Aetna Commercial |
$9,697.81
|
| Rate for Payer: BCBS Trust/PPO |
$8,817.02
|
| Rate for Payer: BCN Commercial |
$8,817.02
|
| Rate for Payer: Cash Price |
$9,127.35
|
| Rate for Payer: Cofinity Commercial |
$9,811.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,127.35
|
| Rate for Payer: Healthscope Commercial |
$10,268.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,556.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,697.81
|
| Rate for Payer: PHP Commercial |
$9,697.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,986.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,926.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,958.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,040.09
|
| Rate for Payer: UHC Core |
$9,526.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,556.89
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,409.19
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,709.68 |
| Max. Negotiated Rate |
$10,268.27 |
| Rate for Payer: Aetna Commercial |
$9,697.81
|
| Rate for Payer: Aetna Medicare |
$2,966.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,565.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,565.37
|
| Rate for Payer: BCBS Complete |
$4,563.68
|
| Rate for Payer: BCBS MAPPO |
$2,852.30
|
| Rate for Payer: BCBS Trust/PPO |
$8,870.65
|
| Rate for Payer: BCN Commercial |
$8,870.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,852.30
|
| Rate for Payer: Cash Price |
$9,127.35
|
| Rate for Payer: Cofinity Commercial |
$9,811.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,127.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,852.30
|
| Rate for Payer: Healthscope Commercial |
$10,268.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,556.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,994.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,280.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,697.81
|
| Rate for Payer: PACE Senior Care Partners |
$2,709.68
|
| Rate for Payer: PACE SWMI |
$2,852.30
|
| Rate for Payer: PHP Commercial |
$9,697.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,852.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,986.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,926.00
|
| Rate for Payer: Priority Health Medicare |
$2,852.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,958.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,852.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,040.09
|
| Rate for Payer: UHC Core |
$9,526.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,852.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,937.87
|
| Rate for Payer: VA VA |
$2,852.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,556.89
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,389.80
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
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 PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,389.80
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
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 PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,296.04
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,230.05 |
| Max. Negotiated Rate |
$4,766.44 |
| Rate for Payer: Aetna Commercial |
$4,501.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,092.78
|
| Rate for Payer: BCN Commercial |
$4,092.78
|
| Rate for Payer: Cash Price |
$4,236.83
|
| Rate for Payer: Cofinity Commercial |
$4,554.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,236.83
|
| Rate for Payer: Healthscope Commercial |
$4,766.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,972.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,501.63
|
| Rate for Payer: PHP Commercial |
$4,501.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,707.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,607.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,230.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,660.52
|
| Rate for Payer: UHC Core |
$4,422.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,972.03
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,296.04
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,257.81 |
| Max. Negotiated Rate |
$4,766.44 |
| Rate for Payer: Aetna Commercial |
$4,501.63
|
| Rate for Payer: Aetna Medicare |
$1,376.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,655.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,655.01
|
| Rate for Payer: BCBS Complete |
$2,118.42
|
| Rate for Payer: BCBS MAPPO |
$1,324.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,117.67
|
| Rate for Payer: BCN Commercial |
$4,117.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.01
|
| Rate for Payer: Cash Price |
$4,236.83
|
| Rate for Payer: Cofinity Commercial |
$4,554.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,236.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.01
|
| Rate for Payer: Healthscope Commercial |
$4,766.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,972.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,390.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,522.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,501.63
|
| Rate for Payer: PACE Senior Care Partners |
$1,257.81
|
| Rate for Payer: PACE SWMI |
$1,324.01
|
| Rate for Payer: PHP Commercial |
$4,501.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,707.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,607.55
|
| Rate for Payer: Priority Health Medicare |
$1,324.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,230.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,324.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,660.52
|
| Rate for Payer: UHC Core |
$4,422.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,363.73
|
| Rate for Payer: VA VA |
$1,324.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,972.03
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,080.22
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,147.93 |
| Max. Negotiated Rate |
$9,072.20 |
| Rate for Payer: Aetna Commercial |
$8,568.19
|
| Rate for Payer: BCBS Trust/PPO |
$7,789.99
|
| Rate for Payer: BCN Commercial |
$7,789.99
|
| Rate for Payer: Cash Price |
$8,064.18
|
| Rate for Payer: Cofinity Commercial |
$8,668.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,064.18
|
| Rate for Payer: Healthscope Commercial |
$9,072.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,560.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,568.19
|
| Rate for Payer: PHP Commercial |
$8,568.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,056.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,769.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,147.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,870.59
|
| Rate for Payer: UHC Core |
$8,416.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,560.16
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,080.22
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,394.05 |
| Max. Negotiated Rate |
$9,072.20 |
| Rate for Payer: Aetna Commercial |
$8,568.19
|
| Rate for Payer: Aetna Medicare |
$2,620.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,150.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,150.07
|
| Rate for Payer: BCBS Complete |
$4,032.09
|
| Rate for Payer: BCBS MAPPO |
$2,520.06
|
| Rate for Payer: BCBS Trust/PPO |
$7,837.37
|
| Rate for Payer: BCN Commercial |
$7,837.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,520.06
|
| Rate for Payer: Cash Price |
$8,064.18
|
| Rate for Payer: Cofinity Commercial |
$8,668.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,064.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,520.06
|
| Rate for Payer: Healthscope Commercial |
$9,072.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,560.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,646.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,898.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,568.19
|
| Rate for Payer: PACE Senior Care Partners |
$2,394.05
|
| Rate for Payer: PACE SWMI |
$2,520.06
|
| Rate for Payer: PHP Commercial |
$8,568.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,520.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,056.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,769.79
|
| Rate for Payer: Priority Health Medicare |
$2,520.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,147.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,520.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,870.59
|
| Rate for Payer: UHC Core |
$8,416.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,520.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,595.66
|
| Rate for Payer: VA VA |
$2,520.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,560.16
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,080.22
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,394.05 |
| Max. Negotiated Rate |
$9,072.20 |
| Rate for Payer: Aetna Commercial |
$8,568.19
|
| Rate for Payer: Aetna Medicare |
$2,620.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,150.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,150.07
|
| Rate for Payer: BCBS Complete |
$4,032.09
|
| Rate for Payer: BCBS MAPPO |
$2,520.06
|
| Rate for Payer: BCBS Trust/PPO |
$7,837.37
|
| Rate for Payer: BCN Commercial |
$7,837.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,520.06
|
| Rate for Payer: Cash Price |
$8,064.18
|
| Rate for Payer: Cofinity Commercial |
$8,668.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,064.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,520.06
|
| Rate for Payer: Healthscope Commercial |
$9,072.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,560.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,646.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,898.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,568.19
|
| Rate for Payer: PACE Senior Care Partners |
$2,394.05
|
| Rate for Payer: PACE SWMI |
$2,520.06
|
| Rate for Payer: PHP Commercial |
$8,568.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,520.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,056.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,769.79
|
| Rate for Payer: Priority Health Medicare |
$2,520.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,147.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,520.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,870.59
|
| Rate for Payer: UHC Core |
$8,416.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,520.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,595.66
|
| Rate for Payer: VA VA |
$2,520.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,560.16
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,080.22
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,147.93 |
| Max. Negotiated Rate |
$9,072.20 |
| Rate for Payer: Aetna Commercial |
$8,568.19
|
| Rate for Payer: BCBS Trust/PPO |
$7,789.99
|
| Rate for Payer: BCN Commercial |
$7,789.99
|
| Rate for Payer: Cash Price |
$8,064.18
|
| Rate for Payer: Cofinity Commercial |
$8,668.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,064.18
|
| Rate for Payer: Healthscope Commercial |
$9,072.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,560.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,568.19
|
| Rate for Payer: PHP Commercial |
$8,568.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,056.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,769.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,147.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,870.59
|
| Rate for Payer: UHC Core |
$8,416.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,560.16
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$1,971.02
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,202.13 |
| Max. Negotiated Rate |
$1,773.92 |
| Rate for Payer: Aetna Commercial |
$1,675.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.20
|
| Rate for Payer: BCN Commercial |
$1,523.20
|
| Rate for Payer: Cash Price |
$1,576.82
|
| Rate for Payer: Cofinity Commercial |
$1,695.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.82
|
| Rate for Payer: Healthscope Commercial |
$1,773.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,675.37
|
| Rate for Payer: PHP Commercial |
$1,675.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,714.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.50
|
| Rate for Payer: UHC Core |
$1,645.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.26
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$1,971.02
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$468.12 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$1,675.37
|
| Rate for Payer: Aetna Medicare |
$512.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$615.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$615.94
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$492.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,532.47
|
| Rate for Payer: BCN Commercial |
$1,532.47
|
| Rate for Payer: BCN Medicare Advantage |
$492.76
|
| Rate for Payer: Cash Price |
$1,576.82
|
| Rate for Payer: Cash Price |
$1,576.82
|
| Rate for Payer: Cofinity Commercial |
$1,695.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,576.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.76
|
| Rate for Payer: Healthscope Commercial |
$1,773.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,478.26
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$517.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$566.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,675.37
|
| Rate for Payer: PACE Senior Care Partners |
$468.12
|
| Rate for Payer: PACE SWMI |
$492.76
|
| Rate for Payer: PHP Commercial |
$1,675.37
|
| Rate for Payer: PHP Medicare Advantage |
$492.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,379.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,714.79
|
| Rate for Payer: Priority Health Medicare |
$492.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.13
|
| Rate for Payer: Railroad Medicare Medicare |
$492.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,734.50
|
| Rate for Payer: UHC Core |
$1,645.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.76
|
| Rate for Payer: UHC Medicare Advantage |
$507.54
|
| Rate for Payer: VA VA |
$492.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,478.26
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,430.91
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,092.51 |
| Max. Negotiated Rate |
$3,087.82 |
| Rate for Payer: Aetna Commercial |
$2,916.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,651.41
|
| Rate for Payer: BCN Commercial |
$2,651.41
|
| Rate for Payer: Cash Price |
$2,744.73
|
| Rate for Payer: Cofinity Commercial |
$2,950.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,744.73
|
| Rate for Payer: Healthscope Commercial |
$3,087.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,573.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,916.27
|
| Rate for Payer: PHP Commercial |
$2,916.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,984.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,092.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,019.20
|
| Rate for Payer: UHC Core |
$2,864.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,573.18
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,430.91
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$814.84 |
| Max. Negotiated Rate |
$3,087.82 |
| Rate for Payer: Aetna Commercial |
$2,916.27
|
| Rate for Payer: Aetna Medicare |
$892.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,072.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,072.16
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$857.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,667.53
|
| Rate for Payer: BCN Commercial |
$2,667.53
|
| Rate for Payer: BCN Medicare Advantage |
$857.73
|
| Rate for Payer: Cash Price |
$2,744.73
|
| Rate for Payer: Cash Price |
$2,744.73
|
| Rate for Payer: Cofinity Commercial |
$2,950.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,744.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.73
|
| Rate for Payer: Healthscope Commercial |
$3,087.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,573.18
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$900.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$986.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,916.27
|
| Rate for Payer: PACE Senior Care Partners |
$814.84
|
| Rate for Payer: PACE SWMI |
$857.73
|
| Rate for Payer: PHP Commercial |
$2,916.27
|
| Rate for Payer: PHP Medicare Advantage |
$857.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,984.89
|
| Rate for Payer: Priority Health Medicare |
$857.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,092.51
|
| Rate for Payer: Railroad Medicare Medicare |
$857.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,019.20
|
| Rate for Payer: UHC Core |
$2,864.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$857.73
|
| Rate for Payer: UHC Medicare Advantage |
$883.46
|
| Rate for Payer: VA VA |
$857.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,573.18
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$121.30
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$109.17 |
| Rate for Payer: Aetna Commercial |
$103.10
|
| Rate for Payer: BCBS Trust/PPO |
$93.74
|
| Rate for Payer: BCN Commercial |
$93.74
|
| Rate for Payer: Cash Price |
$97.04
|
| Rate for Payer: Cofinity Commercial |
$104.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.04
|
| Rate for Payer: Healthscope Commercial |
$109.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.10
|
| Rate for Payer: PHP Commercial |
$103.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.74
|
| Rate for Payer: UHC Core |
$101.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.98
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$121.30
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.31 |
| Max. Negotiated Rate |
$109.17 |
| Rate for Payer: Aetna Commercial |
$103.10
|
| Rate for Payer: Aetna Medicare |
$31.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.91
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$30.32
|
| Rate for Payer: BCBS Trust/PPO |
$94.31
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Medicare Advantage |
$30.32
|
| Rate for Payer: Cash Price |
$97.04
|
| Rate for Payer: Cash Price |
$97.04
|
| Rate for Payer: Cofinity Commercial |
$104.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$109.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.98
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.10
|
| Rate for Payer: PACE Senior Care Partners |
$28.81
|
| Rate for Payer: PACE SWMI |
$30.32
|
| Rate for Payer: PHP Commercial |
$103.10
|
| Rate for Payer: PHP Medicare Advantage |
$30.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.53
|
| Rate for Payer: Priority Health Medicare |
$30.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.98
|
| Rate for Payer: Railroad Medicare Medicare |
$30.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.74
|
| Rate for Payer: UHC Core |
$101.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.32
|
| Rate for Payer: UHC Medicare Advantage |
$31.23
|
| Rate for Payer: VA VA |
$30.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.98
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,417.12
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,084.10 |
| Max. Negotiated Rate |
$3,075.41 |
| Rate for Payer: Aetna Commercial |
$2,904.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.75
|
| Rate for Payer: BCN Commercial |
$2,640.75
|
| Rate for Payer: Cash Price |
$2,733.70
|
| Rate for Payer: Cofinity Commercial |
$2,938.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,733.70
|
| Rate for Payer: Healthscope Commercial |
$3,075.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,562.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,904.55
|
| Rate for Payer: PHP Commercial |
$2,904.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,972.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,084.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,007.07
|
| Rate for Payer: UHC Core |
$2,853.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,562.84
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,417.12
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$811.57 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$2,904.55
|
| Rate for Payer: Aetna Medicare |
$888.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,067.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,067.85
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$854.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,656.81
|
| Rate for Payer: BCN Commercial |
$2,656.81
|
| Rate for Payer: BCN Medicare Advantage |
$854.28
|
| Rate for Payer: Cash Price |
$2,733.70
|
| Rate for Payer: Cash Price |
$2,733.70
|
| Rate for Payer: Cofinity Commercial |
$2,938.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,733.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.28
|
| Rate for Payer: Healthscope Commercial |
$3,075.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,562.84
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$896.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$982.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,904.55
|
| Rate for Payer: PACE Senior Care Partners |
$811.57
|
| Rate for Payer: PACE SWMI |
$854.28
|
| Rate for Payer: PHP Commercial |
$2,904.55
|
| Rate for Payer: PHP Medicare Advantage |
$854.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,972.89
|
| Rate for Payer: Priority Health Medicare |
$854.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,084.10
|
| Rate for Payer: Railroad Medicare Medicare |
$854.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,007.07
|
| Rate for Payer: UHC Core |
$2,853.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$854.28
|
| Rate for Payer: UHC Medicare Advantage |
$879.91
|
| Rate for Payer: VA VA |
$854.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,562.84
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$10,807.38
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,566.75 |
| Max. Negotiated Rate |
$9,726.64 |
| Rate for Payer: Aetna Commercial |
$9,186.27
|
| Rate for Payer: Aetna Medicare |
$2,809.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,377.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,377.31
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$2,701.84
|
| Rate for Payer: BCBS Trust/PPO |
$8,402.74
|
| Rate for Payer: BCN Commercial |
$8,402.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,701.84
|
| Rate for Payer: Cash Price |
$8,645.90
|
| Rate for Payer: Cash Price |
$8,645.90
|
| Rate for Payer: Cofinity Commercial |
$9,294.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,645.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,701.84
|
| Rate for Payer: Healthscope Commercial |
$9,726.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,105.54
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,836.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,107.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,186.27
|
| Rate for Payer: PACE Senior Care Partners |
$2,566.75
|
| Rate for Payer: PACE SWMI |
$2,701.84
|
| Rate for Payer: PHP Commercial |
$9,186.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,701.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,565.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,402.42
|
| Rate for Payer: Priority Health Medicare |
$2,701.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,591.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,701.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,510.49
|
| Rate for Payer: UHC Core |
$9,024.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,701.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,782.90
|
| Rate for Payer: VA VA |
$2,701.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,105.54
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$10,807.38
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,591.42 |
| Max. Negotiated Rate |
$9,726.64 |
| Rate for Payer: Aetna Commercial |
$9,186.27
|
| Rate for Payer: BCBS Trust/PPO |
$8,351.94
|
| Rate for Payer: BCN Commercial |
$8,351.94
|
| Rate for Payer: Cash Price |
$8,645.90
|
| Rate for Payer: Cofinity Commercial |
$9,294.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,645.90
|
| Rate for Payer: Healthscope Commercial |
$9,726.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,105.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,186.27
|
| Rate for Payer: PHP Commercial |
$9,186.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,565.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,402.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,591.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,510.49
|
| Rate for Payer: UHC Core |
$9,024.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,105.54
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$10,896.68
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,587.96 |
| Max. Negotiated Rate |
$9,807.01 |
| Rate for Payer: Aetna Commercial |
$9,262.18
|
| Rate for Payer: Aetna Medicare |
$2,833.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,405.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,405.21
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$2,724.17
|
| Rate for Payer: BCBS Trust/PPO |
$8,472.17
|
| Rate for Payer: BCN Commercial |
$8,472.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,724.17
|
| Rate for Payer: Cash Price |
$8,717.34
|
| Rate for Payer: Cash Price |
$8,717.34
|
| Rate for Payer: Cofinity Commercial |
$9,371.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,717.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,724.17
|
| Rate for Payer: Healthscope Commercial |
$9,807.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,172.51
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,860.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,132.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,262.18
|
| Rate for Payer: PACE Senior Care Partners |
$2,587.96
|
| Rate for Payer: PACE SWMI |
$2,724.17
|
| Rate for Payer: PHP Commercial |
$9,262.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,724.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,627.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,480.11
|
| Rate for Payer: Priority Health Medicare |
$2,724.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,645.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,724.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,589.08
|
| Rate for Payer: UHC Core |
$9,098.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,724.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,805.90
|
| Rate for Payer: VA VA |
$2,724.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,172.51
|
|
