|
HC IR SHEATH
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.51 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.72
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS MAPPO |
$57.38
|
| Rate for Payer: BCBS Trust/PPO |
$178.44
|
| Rate for Payer: BCN Commercial |
$178.44
|
| Rate for Payer: BCN Medicare Advantage |
$57.38
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.38
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PACE Senior Care Partners |
$54.51
|
| Rate for Payer: PACE SWMI |
$57.38
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: PHP Medicare Advantage |
$57.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.66
|
| Rate for Payer: Priority Health Medicare |
$57.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.97
|
| Rate for Payer: Railroad Medicare Medicare |
$57.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.38
|
| Rate for Payer: UHC Medicare Advantage |
$59.10
|
| Rate for Payer: VA VA |
$57.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.97 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: BCBS Trust/PPO |
$177.36
|
| Rate for Payer: BCN Commercial |
$177.36
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$199.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.96
|
| Rate for Payer: UHC Core |
$191.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$435.94 |
| Max. Negotiated Rate |
$643.29 |
| Rate for Payer: Aetna Commercial |
$607.55
|
| Rate for Payer: BCBS Trust/PPO |
$552.37
|
| Rate for Payer: BCN Commercial |
$552.37
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$614.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Healthscope Commercial |
$643.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: PHP Commercial |
$607.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.00
|
| Rate for Payer: UHC Core |
$596.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.08
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$643.29 |
| Rate for Payer: Aetna Commercial |
$607.55
|
| Rate for Payer: Aetna Medicare |
$185.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.37
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$178.69
|
| Rate for Payer: BCBS Trust/PPO |
$555.73
|
| Rate for Payer: BCN Commercial |
$555.73
|
| Rate for Payer: BCN Medicare Advantage |
$178.69
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$614.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.69
|
| Rate for Payer: Healthscope Commercial |
$643.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.08
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: PACE Senior Care Partners |
$169.76
|
| Rate for Payer: PACE SWMI |
$178.69
|
| Rate for Payer: PHP Commercial |
$607.55
|
| Rate for Payer: PHP Medicare Advantage |
$178.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.85
|
| Rate for Payer: Priority Health Medicare |
$178.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.94
|
| Rate for Payer: Railroad Medicare Medicare |
$178.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.00
|
| Rate for Payer: UHC Core |
$596.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.69
|
| Rate for Payer: UHC Medicare Advantage |
$184.05
|
| Rate for Payer: VA VA |
$178.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.08
|
|
|
HC IR SIALOGRAM
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 |
$168.78
|
| 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 |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| 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 |
$160.74
|
| 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 SIALOGRAM
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.11 |
| Max. Negotiated Rate |
$860.62 |
| Rate for Payer: Aetna Commercial |
$812.81
|
| Rate for Payer: Aetna Medicare |
$248.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.83
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$239.06
|
| Rate for Payer: BCBS Trust/PPO |
$743.48
|
| Rate for Payer: BCN Commercial |
$743.48
|
| Rate for Payer: BCN Medicare Advantage |
$239.06
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$822.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.06
|
| Rate for Payer: Healthscope Commercial |
$860.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.19
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.81
|
| Rate for Payer: PACE Senior Care Partners |
$227.11
|
| Rate for Payer: PACE SWMI |
$239.06
|
| Rate for Payer: PHP Commercial |
$812.81
|
| Rate for Payer: PHP Medicare Advantage |
$239.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$831.94
|
| Rate for Payer: Priority Health Medicare |
$239.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.22
|
| Rate for Payer: Railroad Medicare Medicare |
$239.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.50
|
| Rate for Payer: UHC Core |
$798.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.06
|
| Rate for Payer: UHC Medicare Advantage |
$246.23
|
| Rate for Payer: VA VA |
$239.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.19
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.22 |
| Max. Negotiated Rate |
$860.62 |
| Rate for Payer: Aetna Commercial |
$812.81
|
| Rate for Payer: BCBS Trust/PPO |
$738.99
|
| Rate for Payer: BCN Commercial |
$738.99
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$822.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Healthscope Commercial |
$860.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.81
|
| Rate for Payer: PHP Commercial |
$812.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$831.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.50
|
| Rate for Payer: UHC Core |
$798.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.19
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.08 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: BCBS Trust/PPO |
$309.27
|
| Rate for Payer: BCN Commercial |
$309.27
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$95.05 |
| Max. Negotiated Rate |
$379.99 |
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$104.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.06
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$100.05
|
| Rate for Payer: BCBS Trust/PPO |
$311.16
|
| Rate for Payer: BCN Commercial |
$311.16
|
| Rate for Payer: BCN Medicare Advantage |
$100.05
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.05
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Senior Care Partners |
$95.05
|
| Rate for Payer: PACE SWMI |
$100.05
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$100.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.17
|
| Rate for Payer: Priority Health Medicare |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.08
|
| Rate for Payer: Railroad Medicare Medicare |
$100.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.18
|
| Rate for Payer: UHC Core |
$334.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.05
|
| Rate for Payer: UHC Medicare Advantage |
$103.05
|
| Rate for Payer: VA VA |
$100.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,537.29
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$365.11 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: Aetna Medicare |
$399.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.40
|
| Rate for Payer: BCBS Complete |
$614.92
|
| Rate for Payer: BCBS MAPPO |
$384.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.24
|
| Rate for Payer: BCN Commercial |
$1,195.24
|
| Rate for Payer: BCN Medicare Advantage |
$384.32
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.32
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PACE Senior Care Partners |
$365.11
|
| Rate for Payer: PACE SWMI |
$384.32
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: PHP Medicare Advantage |
$384.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.44
|
| Rate for Payer: Priority Health Medicare |
$384.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.59
|
| Rate for Payer: Railroad Medicare Medicare |
$384.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.82
|
| Rate for Payer: UHC Core |
$1,283.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.32
|
| Rate for Payer: UHC Medicare Advantage |
$395.85
|
| Rate for Payer: VA VA |
$384.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$937.59 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.02
|
| Rate for Payer: BCN Commercial |
$1,188.02
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.82
|
| Rate for Payer: UHC Core |
$1,283.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,727.13
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,273.18 |
| Max. Negotiated Rate |
$3,354.42 |
| Rate for Payer: Aetna Commercial |
$3,168.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,880.33
|
| Rate for Payer: BCN Commercial |
$2,880.33
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cofinity Commercial |
$3,205.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,981.70
|
| Rate for Payer: Healthscope Commercial |
$3,354.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,795.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,168.06
|
| Rate for Payer: PHP Commercial |
$3,168.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,242.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,273.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,279.87
|
| Rate for Payer: UHC Core |
$3,112.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,795.35
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,727.13
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$885.19 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$3,168.06
|
| Rate for Payer: Aetna Medicare |
$969.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,164.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,164.73
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$931.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,897.84
|
| Rate for Payer: BCN Commercial |
$2,897.84
|
| Rate for Payer: BCN Medicare Advantage |
$931.78
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cash Price |
$2,981.70
|
| Rate for Payer: Cofinity Commercial |
$3,205.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,981.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$931.78
|
| Rate for Payer: Healthscope Commercial |
$3,354.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,795.35
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$978.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,071.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,168.06
|
| Rate for Payer: PACE Senior Care Partners |
$885.19
|
| Rate for Payer: PACE SWMI |
$931.78
|
| Rate for Payer: PHP Commercial |
$3,168.06
|
| Rate for Payer: PHP Medicare Advantage |
$931.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,608.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,242.60
|
| Rate for Payer: Priority Health Medicare |
$931.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,273.18
|
| Rate for Payer: Railroad Medicare Medicare |
$931.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,279.87
|
| Rate for Payer: UHC Core |
$3,112.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$931.78
|
| Rate for Payer: UHC Medicare Advantage |
$959.74
|
| Rate for Payer: VA VA |
$931.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,795.35
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,602.17
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$618.02 |
| Max. Negotiated Rate |
$2,341.95 |
| Rate for Payer: Aetna Commercial |
$2,211.84
|
| Rate for Payer: Aetna Medicare |
$676.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.18
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$650.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.19
|
| Rate for Payer: BCN Commercial |
$2,023.19
|
| Rate for Payer: BCN Medicare Advantage |
$650.54
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cofinity Commercial |
$2,237.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.54
|
| Rate for Payer: Healthscope Commercial |
$2,341.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,951.63
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$683.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,211.84
|
| Rate for Payer: PACE Senior Care Partners |
$618.02
|
| Rate for Payer: PACE SWMI |
$650.54
|
| Rate for Payer: PHP Commercial |
$2,211.84
|
| Rate for Payer: PHP Medicare Advantage |
$650.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,821.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,263.89
|
| Rate for Payer: Priority Health Medicare |
$650.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,587.06
|
| Rate for Payer: Railroad Medicare Medicare |
$650.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,289.91
|
| Rate for Payer: UHC Core |
$2,172.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.54
|
| Rate for Payer: UHC Medicare Advantage |
$670.06
|
| Rate for Payer: VA VA |
$650.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,951.63
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,602.17
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,587.06 |
| Max. Negotiated Rate |
$2,341.95 |
| Rate for Payer: Aetna Commercial |
$2,211.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,010.96
|
| Rate for Payer: BCN Commercial |
$2,010.96
|
| Rate for Payer: Cash Price |
$2,081.74
|
| Rate for Payer: Cofinity Commercial |
$2,237.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.74
|
| Rate for Payer: Healthscope Commercial |
$2,341.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,951.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,211.84
|
| Rate for Payer: PHP Commercial |
$2,211.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,821.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,263.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,587.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,289.91
|
| Rate for Payer: UHC Core |
$2,172.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,951.63
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$7,341.10
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,743.51 |
| Max. Negotiated Rate |
$12,078.04 |
| Rate for Payer: Aetna Commercial |
$6,239.94
|
| Rate for Payer: Aetna Medicare |
$1,908.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,294.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,294.09
|
| Rate for Payer: BCBS Complete |
$12,078.04
|
| Rate for Payer: BCBS MAPPO |
$1,835.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,707.71
|
| Rate for Payer: BCN Commercial |
$5,707.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,835.28
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cofinity Commercial |
$6,313.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,872.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,835.28
|
| Rate for Payer: Healthscope Commercial |
$6,606.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,505.82
|
| Rate for Payer: Mclaren Medicaid |
$11,502.90
|
| Rate for Payer: Meridian Medicaid |
$12,078.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,927.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,110.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,239.94
|
| Rate for Payer: PACE Senior Care Partners |
$1,743.51
|
| Rate for Payer: PACE SWMI |
$1,835.28
|
| Rate for Payer: PHP Commercial |
$6,239.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,835.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,138.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,386.76
|
| Rate for Payer: Priority Health Medicare |
$1,835.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,477.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,835.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,460.17
|
| Rate for Payer: UHC Core |
$6,129.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,835.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,890.33
|
| Rate for Payer: VA VA |
$1,835.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,505.82
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$7,341.10
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,477.34 |
| Max. Negotiated Rate |
$6,606.99 |
| Rate for Payer: Aetna Commercial |
$6,239.94
|
| Rate for Payer: BCBS Trust/PPO |
$5,673.20
|
| Rate for Payer: BCN Commercial |
$5,673.20
|
| Rate for Payer: Cash Price |
$5,872.88
|
| Rate for Payer: Cofinity Commercial |
$6,313.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,872.88
|
| Rate for Payer: Healthscope Commercial |
$6,606.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,505.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,239.94
|
| Rate for Payer: PHP Commercial |
$6,239.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,138.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,386.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,477.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,460.17
|
| Rate for Payer: UHC Core |
$6,129.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,505.82
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,356.66
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,437.33 |
| Max. Negotiated Rate |
$2,120.99 |
| Rate for Payer: Aetna Commercial |
$2,003.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,821.23
|
| Rate for Payer: BCN Commercial |
$1,821.23
|
| Rate for Payer: Cash Price |
$1,885.33
|
| Rate for Payer: Cofinity Commercial |
$2,026.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.33
|
| Rate for Payer: Healthscope Commercial |
$2,120.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.16
|
| Rate for Payer: PHP Commercial |
$2,003.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,649.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,437.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,073.86
|
| Rate for Payer: UHC Core |
$1,967.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.50
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,356.66
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$559.71 |
| Max. Negotiated Rate |
$2,120.99 |
| Rate for Payer: Aetna Commercial |
$2,003.16
|
| Rate for Payer: Aetna Medicare |
$612.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$736.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$736.46
|
| Rate for Payer: BCBS Complete |
$942.66
|
| Rate for Payer: BCBS MAPPO |
$589.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.30
|
| Rate for Payer: BCN Commercial |
$1,832.30
|
| Rate for Payer: BCN Medicare Advantage |
$589.16
|
| Rate for Payer: Cash Price |
$1,885.33
|
| Rate for Payer: Cofinity Commercial |
$2,026.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,885.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$589.16
|
| Rate for Payer: Healthscope Commercial |
$2,120.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,767.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$618.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$677.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,003.16
|
| Rate for Payer: PACE Senior Care Partners |
$559.71
|
| Rate for Payer: PACE SWMI |
$589.16
|
| Rate for Payer: PHP Commercial |
$2,003.16
|
| Rate for Payer: PHP Medicare Advantage |
$589.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,649.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.29
|
| Rate for Payer: Priority Health Medicare |
$589.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,437.33
|
| Rate for Payer: Railroad Medicare Medicare |
$589.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,073.86
|
| Rate for Payer: UHC Core |
$1,967.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$589.16
|
| Rate for Payer: UHC Medicare Advantage |
$606.84
|
| Rate for Payer: VA VA |
$589.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,767.50
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,605.92
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,419.05 |
| Max. Negotiated Rate |
$5,045.33 |
| Rate for Payer: Aetna Commercial |
$4,765.03
|
| Rate for Payer: BCBS Trust/PPO |
$4,332.25
|
| Rate for Payer: BCN Commercial |
$4,332.25
|
| Rate for Payer: Cash Price |
$4,484.74
|
| Rate for Payer: Cofinity Commercial |
$4,821.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,484.74
|
| Rate for Payer: Healthscope Commercial |
$5,045.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,204.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,765.03
|
| Rate for Payer: PHP Commercial |
$4,765.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,924.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,877.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,419.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,933.21
|
| Rate for Payer: UHC Core |
$4,680.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,204.44
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,605.92
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,331.41 |
| Max. Negotiated Rate |
$5,045.33 |
| Rate for Payer: Aetna Commercial |
$4,765.03
|
| Rate for Payer: Aetna Medicare |
$1,457.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,751.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,751.85
|
| Rate for Payer: BCBS Complete |
$2,242.37
|
| Rate for Payer: BCBS MAPPO |
$1,401.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,358.60
|
| Rate for Payer: BCN Commercial |
$4,358.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,401.48
|
| Rate for Payer: Cash Price |
$4,484.74
|
| Rate for Payer: Cofinity Commercial |
$4,821.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,484.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,401.48
|
| Rate for Payer: Healthscope Commercial |
$5,045.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,204.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,471.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,611.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,765.03
|
| Rate for Payer: PACE Senior Care Partners |
$1,331.41
|
| Rate for Payer: PACE SWMI |
$1,401.48
|
| Rate for Payer: PHP Commercial |
$4,765.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,401.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,924.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,877.15
|
| Rate for Payer: Priority Health Medicare |
$1,401.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,419.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,401.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,933.21
|
| Rate for Payer: UHC Core |
$4,680.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,401.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,443.52
|
| Rate for Payer: VA VA |
$1,401.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,204.44
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,296.32
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,732.88 |
| Max. Negotiated Rate |
$7,577.51 |
| Rate for Payer: Aetna Commercial |
$6,201.87
|
| Rate for Payer: Aetna Medicare |
$1,897.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,280.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,280.10
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$1,824.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,672.89
|
| Rate for Payer: BCN Commercial |
$5,672.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,824.08
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cofinity Commercial |
$6,274.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,837.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,824.08
|
| Rate for Payer: Healthscope Commercial |
$6,566.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,472.24
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,915.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,097.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,201.87
|
| Rate for Payer: PACE Senior Care Partners |
$1,732.88
|
| Rate for Payer: PACE SWMI |
$1,824.08
|
| Rate for Payer: PHP Commercial |
$6,201.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,824.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,347.80
|
| Rate for Payer: Priority Health Medicare |
$1,824.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,450.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,824.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,420.76
|
| Rate for Payer: UHC Core |
$6,092.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,824.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,878.80
|
| Rate for Payer: VA VA |
$1,824.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,472.24
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,296.32
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,450.03 |
| Max. Negotiated Rate |
$6,566.69 |
| Rate for Payer: Aetna Commercial |
$6,201.87
|
| Rate for Payer: BCBS Trust/PPO |
$5,638.60
|
| Rate for Payer: BCN Commercial |
$5,638.60
|
| Rate for Payer: Cash Price |
$5,837.06
|
| Rate for Payer: Cofinity Commercial |
$6,274.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,837.06
|
| Rate for Payer: Healthscope Commercial |
$6,566.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,472.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,201.87
|
| Rate for Payer: PHP Commercial |
$6,201.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,107.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,347.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,450.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,420.76
|
| Rate for Payer: UHC Core |
$6,092.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,472.24
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,264.30
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.27 |
| Max. Negotiated Rate |
$4,737.87 |
| Rate for Payer: Aetna Commercial |
$4,474.66
|
| Rate for Payer: Aetna Medicare |
$1,368.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,645.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,645.09
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,316.08
|
| Rate for Payer: BCBS Trust/PPO |
$4,092.99
|
| Rate for Payer: BCN Commercial |
$4,092.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,316.08
|
| Rate for Payer: Cash Price |
$4,211.44
|
| Rate for Payer: Cash Price |
$4,211.44
|
| Rate for Payer: Cofinity Commercial |
$4,527.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,211.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,316.08
|
| Rate for Payer: Healthscope Commercial |
$4,737.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,948.22
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,381.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,513.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,474.66
|
| Rate for Payer: PACE Senior Care Partners |
$1,250.27
|
| Rate for Payer: PACE SWMI |
$1,316.08
|
| Rate for Payer: PHP Commercial |
$4,474.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,316.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,685.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,579.94
|
| Rate for Payer: Priority Health Medicare |
$1,316.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,210.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,316.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,632.58
|
| Rate for Payer: UHC Core |
$4,395.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,316.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,355.56
|
| Rate for Payer: VA VA |
$1,316.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,948.22
|
|
