|
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
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,081.27
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,681.80 |
| Max. Negotiated Rate |
$6,373.14 |
| Rate for Payer: Aetna Commercial |
$6,019.08
|
| Rate for Payer: Aetna Medicare |
$1,841.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,212.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,212.90
|
| Rate for Payer: BCBS Complete |
$2,832.51
|
| Rate for Payer: BCBS MAPPO |
$1,770.32
|
| Rate for Payer: BCBS Trust/PPO |
$5,505.69
|
| Rate for Payer: BCN Commercial |
$5,505.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,770.32
|
| Rate for Payer: Cash Price |
$5,665.02
|
| Rate for Payer: Cofinity Commercial |
$6,089.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,665.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,770.32
|
| Rate for Payer: Healthscope Commercial |
$6,373.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,858.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,035.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,681.80
|
| Rate for Payer: PACE SWMI |
$1,770.32
|
| Rate for Payer: PHP Commercial |
$6,019.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,770.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,160.70
|
| Rate for Payer: Priority Health Medicare |
$1,770.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,318.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,770.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,231.52
|
| Rate for Payer: UHC Core |
$5,912.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,770.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,823.43
|
| Rate for Payer: VA VA |
$1,770.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.95
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,081.27
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,318.87 |
| Max. Negotiated Rate |
$6,373.14 |
| Rate for Payer: Aetna Commercial |
$6,019.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.41
|
| Rate for Payer: BCN Commercial |
$5,472.41
|
| Rate for Payer: Cash Price |
$5,665.02
|
| Rate for Payer: Cofinity Commercial |
$6,089.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,665.02
|
| Rate for Payer: Healthscope Commercial |
$6,373.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,019.08
|
| Rate for Payer: PHP Commercial |
$6,019.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,160.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,318.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,231.52
|
| Rate for Payer: UHC Core |
$5,912.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.95
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,174.50
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,891.44 |
| Max. Negotiated Rate |
$10,957.05 |
| Rate for Payer: Aetna Commercial |
$10,348.32
|
| Rate for Payer: Aetna Medicare |
$3,165.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,804.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,804.53
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$3,043.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,465.67
|
| Rate for Payer: BCN Commercial |
$9,465.67
|
| Rate for Payer: BCN Medicare Advantage |
$3,043.62
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cofinity Commercial |
$10,470.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,739.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,043.62
|
| Rate for Payer: Healthscope Commercial |
$10,957.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,130.88
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,195.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,500.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
| Rate for Payer: PACE Senior Care Partners |
$2,891.44
|
| Rate for Payer: PACE SWMI |
$3,043.62
|
| Rate for Payer: PHP Commercial |
$10,348.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,043.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,591.82
|
| Rate for Payer: Priority Health Medicare |
$3,043.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,425.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,043.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,713.56
|
| Rate for Payer: UHC Core |
$10,165.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,043.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,134.93
|
| Rate for Payer: VA VA |
$3,043.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,130.88
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,174.50
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,425.23 |
| Max. Negotiated Rate |
$10,957.05 |
| Rate for Payer: Aetna Commercial |
$10,348.32
|
| Rate for Payer: BCBS Trust/PPO |
$9,408.45
|
| Rate for Payer: BCN Commercial |
$9,408.45
|
| Rate for Payer: Cash Price |
$9,739.60
|
| Rate for Payer: Cofinity Commercial |
$10,470.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,739.60
|
| Rate for Payer: Healthscope Commercial |
$10,957.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,130.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,348.32
|
| Rate for Payer: PHP Commercial |
$10,348.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,522.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,591.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,425.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,713.56
|
| Rate for Payer: UHC Core |
$10,165.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,130.88
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,437.71
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,195.66 |
| Max. Negotiated Rate |
$12,093.94 |
| Rate for Payer: Aetna Commercial |
$11,422.05
|
| Rate for Payer: BCBS Trust/PPO |
$10,384.66
|
| Rate for Payer: BCN Commercial |
$10,384.66
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cofinity Commercial |
$11,556.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,750.17
|
| Rate for Payer: Healthscope Commercial |
$12,093.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,078.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
| Rate for Payer: PHP Commercial |
$11,422.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,690.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,195.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,825.18
|
| Rate for Payer: UHC Core |
$11,220.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,078.28
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,437.71
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,191.46 |
| Max. Negotiated Rate |
$12,093.94 |
| Rate for Payer: Aetna Commercial |
$11,422.05
|
| Rate for Payer: Aetna Medicare |
$3,493.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,199.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,199.28
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$3,359.43
|
| Rate for Payer: BCBS Trust/PPO |
$10,447.82
|
| Rate for Payer: BCN Commercial |
$10,447.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,359.43
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cash Price |
$10,750.17
|
| Rate for Payer: Cofinity Commercial |
$11,556.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,750.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,359.43
|
| Rate for Payer: Healthscope Commercial |
$12,093.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,078.28
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,527.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,863.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,422.05
|
| Rate for Payer: PACE Senior Care Partners |
$3,191.46
|
| Rate for Payer: PACE SWMI |
$3,359.43
|
| Rate for Payer: PHP Commercial |
$11,422.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,359.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,406.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,690.81
|
| Rate for Payer: Priority Health Medicare |
$3,359.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,195.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,359.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,825.18
|
| Rate for Payer: UHC Core |
$11,220.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,359.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,460.21
|
| Rate for Payer: VA VA |
$3,359.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,078.28
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,435.33
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,765.89 |
| Max. Negotiated Rate |
$6,691.80 |
| Rate for Payer: Aetna Commercial |
$6,320.03
|
| Rate for Payer: Aetna Medicare |
$1,933.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.54
|
| Rate for Payer: BCBS Complete |
$2,974.13
|
| Rate for Payer: BCBS MAPPO |
$1,858.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,780.97
|
| Rate for Payer: BCN Commercial |
$5,780.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.83
|
| Rate for Payer: Cash Price |
$5,948.26
|
| Rate for Payer: Cofinity Commercial |
$6,394.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.83
|
| Rate for Payer: Healthscope Commercial |
$6,691.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,576.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,951.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
| Rate for Payer: PACE Senior Care Partners |
$1,765.89
|
| Rate for Payer: PACE SWMI |
$1,858.83
|
| Rate for Payer: PHP Commercial |
$6,320.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,468.74
|
| Rate for Payer: Priority Health Medicare |
$1,858.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,534.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,543.09
|
| Rate for Payer: UHC Core |
$6,208.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,914.60
|
| Rate for Payer: VA VA |
$1,858.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,576.50
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,435.33
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,534.81 |
| Max. Negotiated Rate |
$6,691.80 |
| Rate for Payer: Aetna Commercial |
$6,320.03
|
| Rate for Payer: BCBS Trust/PPO |
$5,746.02
|
| Rate for Payer: BCN Commercial |
$5,746.02
|
| Rate for Payer: Cash Price |
$5,948.26
|
| Rate for Payer: Cofinity Commercial |
$6,394.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,948.26
|
| Rate for Payer: Healthscope Commercial |
$6,691.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,576.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,320.03
|
| Rate for Payer: PHP Commercial |
$6,320.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,204.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,468.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,534.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,543.09
|
| Rate for Payer: UHC Core |
$6,208.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,576.50
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,133.54
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,400.25 |
| Max. Negotiated Rate |
$10,920.19 |
| Rate for Payer: Aetna Commercial |
$10,313.51
|
| Rate for Payer: BCBS Trust/PPO |
$9,376.80
|
| Rate for Payer: BCN Commercial |
$9,376.80
|
| Rate for Payer: Cash Price |
$9,706.83
|
| Rate for Payer: Cofinity Commercial |
$10,434.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,706.83
|
| Rate for Payer: Healthscope Commercial |
$10,920.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,100.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
| Rate for Payer: PHP Commercial |
$10,313.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,556.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,400.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,677.52
|
| Rate for Payer: UHC Core |
$10,131.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,100.16
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,133.54
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,881.72 |
| Max. Negotiated Rate |
$10,920.19 |
| Rate for Payer: Aetna Commercial |
$10,313.51
|
| Rate for Payer: Aetna Medicare |
$3,154.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,791.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,791.73
|
| Rate for Payer: BCBS Complete |
$4,853.42
|
| Rate for Payer: BCBS MAPPO |
$3,033.38
|
| Rate for Payer: BCBS Trust/PPO |
$9,433.83
|
| Rate for Payer: BCN Commercial |
$9,433.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,033.38
|
| Rate for Payer: Cash Price |
$9,706.83
|
| Rate for Payer: Cofinity Commercial |
$10,434.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,706.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,033.38
|
| Rate for Payer: Healthscope Commercial |
$10,920.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,100.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,185.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,488.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,313.51
|
| Rate for Payer: PACE Senior Care Partners |
$2,881.72
|
| Rate for Payer: PACE SWMI |
$3,033.38
|
| Rate for Payer: PHP Commercial |
$10,313.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,033.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,493.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,556.18
|
| Rate for Payer: Priority Health Medicare |
$3,033.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,400.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,033.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,677.52
|
| Rate for Payer: UHC Core |
$10,131.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,033.38
|
| Rate for Payer: UHC Medicare Advantage |
$3,124.39
|
| Rate for Payer: VA VA |
$3,033.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,100.16
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,289.72 |
| Max. Negotiated Rate |
$9,281.43 |
| Rate for Payer: Aetna Commercial |
$8,765.80
|
| Rate for Payer: BCBS Trust/PPO |
$7,969.65
|
| Rate for Payer: BCN Commercial |
$7,969.65
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$8,868.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Healthscope Commercial |
$9,281.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,734.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: PHP Commercial |
$8,765.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,972.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,289.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,075.18
|
| Rate for Payer: UHC Core |
$8,611.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,734.52
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,449.27 |
| Max. Negotiated Rate |
$9,281.43 |
| Rate for Payer: Aetna Commercial |
$8,765.80
|
| Rate for Payer: Aetna Medicare |
$2,681.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,222.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,222.72
|
| Rate for Payer: BCBS Complete |
$4,125.08
|
| Rate for Payer: BCBS MAPPO |
$2,578.18
|
| Rate for Payer: BCBS Trust/PPO |
$8,018.12
|
| Rate for Payer: BCN Commercial |
$8,018.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,578.18
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$8,868.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,578.18
|
| Rate for Payer: Healthscope Commercial |
$9,281.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,734.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,707.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,964.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: PACE Senior Care Partners |
$2,449.27
|
| Rate for Payer: PACE SWMI |
$2,578.18
|
| Rate for Payer: PHP Commercial |
$8,765.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,578.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,972.05
|
| Rate for Payer: Priority Health Medicare |
$2,578.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,289.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,578.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,075.18
|
| Rate for Payer: UHC Core |
$8,611.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,578.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,655.52
|
| Rate for Payer: VA VA |
$2,578.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,734.52
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,650.68 |
| Max. Negotiated Rate |
$10,044.68 |
| Rate for Payer: Aetna Commercial |
$9,486.65
|
| Rate for Payer: Aetna Medicare |
$2,901.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,487.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,487.74
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$2,790.19
|
| Rate for Payer: BCBS Trust/PPO |
$8,677.49
|
| Rate for Payer: BCN Commercial |
$8,677.49
|
| Rate for Payer: BCN Medicare Advantage |
$2,790.19
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$9,598.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,790.19
|
| Rate for Payer: Healthscope Commercial |
$10,044.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,370.57
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,929.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,208.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: PACE Senior Care Partners |
$2,650.68
|
| Rate for Payer: PACE SWMI |
$2,790.19
|
| Rate for Payer: PHP Commercial |
$9,486.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,790.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,709.86
|
| Rate for Payer: Priority Health Medicare |
$2,790.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,806.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,790.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,821.47
|
| Rate for Payer: UHC Core |
$9,319.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,790.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,873.90
|
| Rate for Payer: VA VA |
$2,790.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,370.57
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,806.95 |
| Max. Negotiated Rate |
$10,044.68 |
| Rate for Payer: Aetna Commercial |
$9,486.65
|
| Rate for Payer: BCBS Trust/PPO |
$8,625.04
|
| Rate for Payer: BCN Commercial |
$8,625.04
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$9,598.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Healthscope Commercial |
$10,044.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,370.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: PHP Commercial |
$9,486.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,709.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,806.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,821.47
|
| Rate for Payer: UHC Core |
$9,319.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,370.57
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.98 |
| Max. Negotiated Rate |
$160.81 |
| Rate for Payer: Aetna Commercial |
$151.88
|
| Rate for Payer: BCBS Trust/PPO |
$138.08
|
| Rate for Payer: BCN Commercial |
$138.08
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Healthscope Commercial |
$160.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: PHP Commercial |
$151.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.24
|
| Rate for Payer: UHC Core |
$149.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.01
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$160.81 |
| Rate for Payer: Aetna Commercial |
$151.88
|
| Rate for Payer: Aetna Medicare |
$46.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.84
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$44.67
|
| Rate for Payer: BCBS Trust/PPO |
$138.92
|
| Rate for Payer: BCN Commercial |
$138.92
|
| Rate for Payer: BCN Medicare Advantage |
$44.67
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.67
|
| Rate for Payer: Healthscope Commercial |
$160.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.01
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: PACE Senior Care Partners |
$42.44
|
| Rate for Payer: PACE SWMI |
$44.67
|
| Rate for Payer: PHP Commercial |
$151.88
|
| Rate for Payer: PHP Medicare Advantage |
$44.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.45
|
| Rate for Payer: Priority Health Medicare |
$44.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.98
|
| Rate for Payer: Railroad Medicare Medicare |
$44.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.24
|
| Rate for Payer: UHC Core |
$149.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.67
|
| Rate for Payer: UHC Medicare Advantage |
$46.01
|
| Rate for Payer: VA VA |
$44.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.01
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Aetna Commercial |
$36.34
|
| Rate for Payer: Aetna Medicare |
$11.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.36
|
| Rate for Payer: BCBS Complete |
$17.10
|
| Rate for Payer: BCBS MAPPO |
$10.69
|
| Rate for Payer: BCBS Trust/PPO |
$33.24
|
| Rate for Payer: BCN Commercial |
$33.24
|
| Rate for Payer: BCN Medicare Advantage |
$10.69
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.69
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: PACE Senior Care Partners |
$10.15
|
| Rate for Payer: PACE SWMI |
$10.69
|
| Rate for Payer: PHP Commercial |
$36.34
|
| Rate for Payer: PHP Medicare Advantage |
$10.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Medicare |
$10.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.62
|
| Rate for Payer: UHC Core |
$35.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.69
|
| Rate for Payer: UHC Medicare Advantage |
$11.01
|
| Rate for Payer: VA VA |
$10.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.06
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Aetna Commercial |
$36.34
|
| Rate for Payer: BCBS Trust/PPO |
$33.04
|
| Rate for Payer: BCN Commercial |
$33.04
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: PHP Commercial |
$36.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.62
|
| Rate for Payer: UHC Core |
$35.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.06
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.95 |
| Max. Negotiated Rate |
$318.66 |
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: BCBS Trust/PPO |
$273.63
|
| Rate for Payer: BCN Commercial |
$273.63
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$304.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Healthscope Commercial |
$318.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: PHP Commercial |
$300.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.58
|
| Rate for Payer: UHC Core |
$295.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.09 |
| Max. Negotiated Rate |
$318.66 |
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: Aetna Medicare |
$92.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.65
|
| Rate for Payer: BCBS Complete |
$170.23
|
| Rate for Payer: BCBS MAPPO |
$88.52
|
| Rate for Payer: BCBS Trust/PPO |
$275.29
|
| Rate for Payer: BCN Commercial |
$275.29
|
| Rate for Payer: BCN Medicare Advantage |
$88.52
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$304.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.52
|
| Rate for Payer: Healthscope Commercial |
$318.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
| Rate for Payer: Mclaren Medicaid |
$162.12
|
| Rate for Payer: Meridian Medicaid |
$170.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: PACE Senior Care Partners |
$84.09
|
| Rate for Payer: PACE SWMI |
$88.52
|
| Rate for Payer: PHP Commercial |
$300.96
|
| Rate for Payer: PHP Medicare Advantage |
$88.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.04
|
| Rate for Payer: Priority Health Medicare |
$88.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.95
|
| Rate for Payer: Railroad Medicare Medicare |
$88.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.58
|
| Rate for Payer: UHC Core |
$295.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.52
|
| Rate for Payer: UHC Medicare Advantage |
$91.17
|
| Rate for Payer: VA VA |
$88.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna Commercial |
$15.06
|
| Rate for Payer: Aetna Medicare |
$4.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.54
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$4.43
|
| Rate for Payer: BCBS Trust/PPO |
$13.78
|
| Rate for Payer: BCN Commercial |
$13.78
|
| Rate for Payer: BCN Medicare Advantage |
$4.43
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$15.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.43
|
| Rate for Payer: Healthscope Commercial |
$15.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.21
|
| Rate for Payer: PACE SWMI |
$4.43
|
| Rate for Payer: PHP Commercial |
$15.06
|
| Rate for Payer: PHP Medicare Advantage |
$4.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.42
|
| Rate for Payer: Priority Health Medicare |
$4.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.59
|
| Rate for Payer: UHC Core |
$14.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.43
|
| Rate for Payer: UHC Medicare Advantage |
$4.56
|
| Rate for Payer: VA VA |
$4.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.29
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.81 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna Commercial |
$15.06
|
| Rate for Payer: BCBS Trust/PPO |
$13.69
|
| Rate for Payer: BCN Commercial |
$13.69
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$15.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$15.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: PHP Commercial |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.59
|
| Rate for Payer: UHC Core |
$14.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.29
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$456.31 |
| Max. Negotiated Rate |
$1,729.18 |
| Rate for Payer: Aetna Commercial |
$1,633.11
|
| Rate for Payer: Aetna Medicare |
$499.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.41
|
| Rate for Payer: BCBS Complete |
$768.52
|
| Rate for Payer: BCBS MAPPO |
$480.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,493.82
|
| Rate for Payer: BCN Commercial |
$1,493.82
|
| Rate for Payer: BCN Medicare Advantage |
$480.33
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,652.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.33
|
| Rate for Payer: Healthscope Commercial |
$1,729.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: PACE Senior Care Partners |
$456.31
|
| Rate for Payer: PACE SWMI |
$480.33
|
| Rate for Payer: PHP Commercial |
$1,633.11
|
| Rate for Payer: PHP Medicare Advantage |
$480.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.54
|
| Rate for Payer: Priority Health Medicare |
$480.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.81
|
| Rate for Payer: Railroad Medicare Medicare |
$480.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.75
|
| Rate for Payer: UHC Core |
$1,604.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$480.33
|
| Rate for Payer: UHC Medicare Advantage |
$494.74
|
| Rate for Payer: VA VA |
$480.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.98
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,171.81 |
| Max. Negotiated Rate |
$1,729.18 |
| Rate for Payer: Aetna Commercial |
$1,633.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.79
|
| Rate for Payer: BCN Commercial |
$1,484.79
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,652.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Healthscope Commercial |
$1,729.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: PHP Commercial |
$1,633.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.75
|
| Rate for Payer: UHC Core |
$1,604.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.98
|
|
