|
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
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,763.20
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$418.76 |
| Max. Negotiated Rate |
$1,586.88 |
| Rate for Payer: Aetna Commercial |
$1,498.72
|
| Rate for Payer: Aetna Medicare |
$458.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.00
|
| Rate for Payer: BCBS Complete |
$705.28
|
| Rate for Payer: BCBS MAPPO |
$440.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,370.89
|
| Rate for Payer: BCN Commercial |
$1,370.89
|
| Rate for Payer: BCN Medicare Advantage |
$440.80
|
| Rate for Payer: Cash Price |
$1,410.56
|
| Rate for Payer: Cofinity Commercial |
$1,516.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,410.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.80
|
| Rate for Payer: Healthscope Commercial |
$1,586.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,322.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,498.72
|
| Rate for Payer: PACE Senior Care Partners |
$418.76
|
| Rate for Payer: PACE SWMI |
$440.80
|
| Rate for Payer: PHP Commercial |
$1,498.72
|
| Rate for Payer: PHP Medicare Advantage |
$440.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.98
|
| Rate for Payer: Priority Health Medicare |
$440.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.38
|
| Rate for Payer: Railroad Medicare Medicare |
$440.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,551.62
|
| Rate for Payer: UHC Core |
$1,472.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.80
|
| Rate for Payer: UHC Medicare Advantage |
$454.02
|
| Rate for Payer: VA VA |
$440.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,322.40
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,763.20
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,075.38 |
| Max. Negotiated Rate |
$1,586.88 |
| Rate for Payer: Aetna Commercial |
$1,498.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.60
|
| Rate for Payer: BCN Commercial |
$1,362.60
|
| Rate for Payer: Cash Price |
$1,410.56
|
| Rate for Payer: Cofinity Commercial |
$1,516.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,410.56
|
| Rate for Payer: Healthscope Commercial |
$1,586.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,322.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,498.72
|
| Rate for Payer: PHP Commercial |
$1,498.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,551.62
|
| Rate for Payer: UHC Core |
$1,472.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,322.40
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,129.88
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.12 |
| Max. Negotiated Rate |
$1,916.89 |
| Rate for Payer: Aetna Commercial |
$1,810.40
|
| Rate for Payer: Aetna Medicare |
$553.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$665.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$665.59
|
| Rate for Payer: BCBS Complete |
$170.23
|
| Rate for Payer: BCBS MAPPO |
$532.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,655.98
|
| Rate for Payer: BCN Commercial |
$1,655.98
|
| Rate for Payer: BCN Medicare Advantage |
$532.47
|
| Rate for Payer: Cash Price |
$1,703.90
|
| Rate for Payer: Cash Price |
$1,703.90
|
| Rate for Payer: Cofinity Commercial |
$1,831.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.47
|
| Rate for Payer: Healthscope Commercial |
$1,916.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.41
|
| Rate for Payer: Mclaren Medicaid |
$162.12
|
| Rate for Payer: Meridian Medicaid |
$170.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$612.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,810.40
|
| Rate for Payer: PACE Senior Care Partners |
$505.85
|
| Rate for Payer: PACE SWMI |
$532.47
|
| Rate for Payer: PHP Commercial |
$1,810.40
|
| Rate for Payer: PHP Medicare Advantage |
$532.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,490.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.00
|
| Rate for Payer: Priority Health Medicare |
$532.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,299.01
|
| Rate for Payer: Railroad Medicare Medicare |
$532.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.29
|
| Rate for Payer: UHC Core |
$1,778.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$532.47
|
| Rate for Payer: UHC Medicare Advantage |
$548.44
|
| Rate for Payer: VA VA |
$532.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.41
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,129.88
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,299.01 |
| Max. Negotiated Rate |
$1,916.89 |
| Rate for Payer: Aetna Commercial |
$1,810.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,645.97
|
| Rate for Payer: BCN Commercial |
$1,645.97
|
| Rate for Payer: Cash Price |
$1,703.90
|
| Rate for Payer: Cofinity Commercial |
$1,831.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,703.90
|
| Rate for Payer: Healthscope Commercial |
$1,916.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,597.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,810.40
|
| Rate for Payer: PHP Commercial |
$1,810.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,490.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,853.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,299.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,874.29
|
| Rate for Payer: UHC Core |
$1,778.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,597.41
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$454.34
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$408.91 |
| Rate for Payer: Aetna Commercial |
$386.19
|
| Rate for Payer: Aetna Medicare |
$118.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.98
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$113.58
|
| Rate for Payer: BCBS Trust/PPO |
$353.25
|
| Rate for Payer: BCN Commercial |
$353.25
|
| Rate for Payer: BCN Medicare Advantage |
$113.58
|
| Rate for Payer: Cash Price |
$363.47
|
| Rate for Payer: Cash Price |
$363.47
|
| Rate for Payer: Cofinity Commercial |
$390.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.58
|
| Rate for Payer: Healthscope Commercial |
$408.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.76
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.19
|
| Rate for Payer: PACE Senior Care Partners |
$107.91
|
| Rate for Payer: PACE SWMI |
$113.58
|
| Rate for Payer: PHP Commercial |
$386.19
|
| Rate for Payer: PHP Medicare Advantage |
$113.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.28
|
| Rate for Payer: Priority Health Medicare |
$113.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.10
|
| Rate for Payer: Railroad Medicare Medicare |
$113.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.82
|
| Rate for Payer: UHC Core |
$379.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.58
|
| Rate for Payer: UHC Medicare Advantage |
$116.99
|
| Rate for Payer: VA VA |
$113.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.76
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$454.34
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$277.10 |
| Max. Negotiated Rate |
$408.91 |
| Rate for Payer: Aetna Commercial |
$386.19
|
| Rate for Payer: BCBS Trust/PPO |
$351.11
|
| Rate for Payer: BCN Commercial |
$351.11
|
| Rate for Payer: Cash Price |
$363.47
|
| Rate for Payer: Cofinity Commercial |
$390.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.47
|
| Rate for Payer: Healthscope Commercial |
$408.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.19
|
| Rate for Payer: PHP Commercial |
$386.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.82
|
| Rate for Payer: UHC Core |
$379.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.76
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$83.21 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$91.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.49
|
| Rate for Payer: BCBS Complete |
$140.15
|
| Rate for Payer: BCBS MAPPO |
$87.59
|
| Rate for Payer: BCBS Trust/PPO |
$272.41
|
| Rate for Payer: BCN Commercial |
$272.41
|
| Rate for Payer: BCN Medicare Advantage |
$87.59
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.59
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Senior Care Partners |
$83.21
|
| Rate for Payer: PACE SWMI |
$87.59
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$87.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Medicare |
$87.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: Railroad Medicare Medicare |
$87.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.59
|
| Rate for Payer: UHC Medicare Advantage |
$90.22
|
| Rate for Payer: VA VA |
$87.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$213.69 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: BCBS Trust/PPO |
$270.77
|
| Rate for Payer: BCN Commercial |
$270.77
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.33
|
| Rate for Payer: UHC Core |
$292.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$480.78
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.19 |
| Max. Negotiated Rate |
$432.70 |
| Rate for Payer: Aetna Commercial |
$408.66
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.24
|
| Rate for Payer: BCBS Complete |
$192.31
|
| Rate for Payer: BCBS MAPPO |
$120.20
|
| Rate for Payer: BCBS Trust/PPO |
$373.81
|
| Rate for Payer: BCN Commercial |
$373.81
|
| Rate for Payer: BCN Medicare Advantage |
$120.20
|
| Rate for Payer: Cash Price |
$384.62
|
| Rate for Payer: Cofinity Commercial |
$413.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.20
|
| Rate for Payer: Healthscope Commercial |
$432.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.66
|
| Rate for Payer: PACE Senior Care Partners |
$114.19
|
| Rate for Payer: PACE SWMI |
$120.20
|
| Rate for Payer: PHP Commercial |
$408.66
|
| Rate for Payer: PHP Medicare Advantage |
$120.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.28
|
| Rate for Payer: Priority Health Medicare |
$120.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.23
|
| Rate for Payer: Railroad Medicare Medicare |
$120.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.09
|
| Rate for Payer: UHC Core |
$401.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.20
|
| Rate for Payer: UHC Medicare Advantage |
$123.80
|
| Rate for Payer: VA VA |
$120.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.58
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$480.78
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$293.23 |
| Max. Negotiated Rate |
$432.70 |
| Rate for Payer: Aetna Commercial |
$408.66
|
| Rate for Payer: BCBS Trust/PPO |
$371.55
|
| Rate for Payer: BCN Commercial |
$371.55
|
| Rate for Payer: Cash Price |
$384.62
|
| Rate for Payer: Cofinity Commercial |
$413.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.62
|
| Rate for Payer: Healthscope Commercial |
$432.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.66
|
| Rate for Payer: PHP Commercial |
$408.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.09
|
| Rate for Payer: UHC Core |
$401.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.58
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,100.68
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$671.30 |
| Max. Negotiated Rate |
$990.61 |
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: BCBS Trust/PPO |
$850.61
|
| Rate for Payer: BCN Commercial |
$850.61
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.60
|
| Rate for Payer: UHC Core |
$919.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,100.68
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$261.41 |
| Max. Negotiated Rate |
$1,103.12 |
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: Aetna Medicare |
$286.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$343.96
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$275.17
|
| Rate for Payer: BCBS Trust/PPO |
$855.78
|
| Rate for Payer: BCN Commercial |
$855.78
|
| Rate for Payer: BCN Medicare Advantage |
$275.17
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.17
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$316.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PACE Senior Care Partners |
$261.41
|
| Rate for Payer: PACE SWMI |
$275.17
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: PHP Medicare Advantage |
$275.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.59
|
| Rate for Payer: Priority Health Medicare |
$275.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.30
|
| Rate for Payer: Railroad Medicare Medicare |
$275.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.60
|
| Rate for Payer: UHC Core |
$919.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.17
|
| Rate for Payer: UHC Medicare Advantage |
$283.43
|
| Rate for Payer: VA VA |
$275.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,400.83
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$854.37 |
| Max. Negotiated Rate |
$1,260.75 |
| Rate for Payer: Aetna Commercial |
$1,190.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,082.56
|
| Rate for Payer: BCN Commercial |
$1,082.56
|
| Rate for Payer: Cash Price |
$1,120.66
|
| Rate for Payer: Cofinity Commercial |
$1,204.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,120.66
|
| Rate for Payer: Healthscope Commercial |
$1,260.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,050.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,190.71
|
| Rate for Payer: PHP Commercial |
$1,190.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,232.73
|
| Rate for Payer: UHC Core |
$1,169.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,050.62
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,400.83
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$332.70 |
| Max. Negotiated Rate |
$1,260.75 |
| Rate for Payer: Aetna Commercial |
$1,190.71
|
| Rate for Payer: Aetna Medicare |
$364.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.76
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$350.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.15
|
| Rate for Payer: BCN Commercial |
$1,089.15
|
| Rate for Payer: BCN Medicare Advantage |
$350.21
|
| Rate for Payer: Cash Price |
$1,120.66
|
| Rate for Payer: Cash Price |
$1,120.66
|
| Rate for Payer: Cofinity Commercial |
$1,204.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,120.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.21
|
| Rate for Payer: Healthscope Commercial |
$1,260.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,050.62
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$367.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,190.71
|
| Rate for Payer: PACE Senior Care Partners |
$332.70
|
| Rate for Payer: PACE SWMI |
$350.21
|
| Rate for Payer: PHP Commercial |
$1,190.71
|
| Rate for Payer: PHP Medicare Advantage |
$350.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,218.72
|
| Rate for Payer: Priority Health Medicare |
$350.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.37
|
| Rate for Payer: Railroad Medicare Medicare |
$350.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,232.73
|
| Rate for Payer: UHC Core |
$1,169.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.21
|
| Rate for Payer: UHC Medicare Advantage |
$360.71
|
| Rate for Payer: VA VA |
$350.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,050.62
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,727.13
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,727.13
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$885.19 |
| Max. Negotiated Rate |
$3,354.42 |
| 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 |
$2,195.52
|
| 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 |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| 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 |
$2,090.97
|
| 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 VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,500.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$831.29 |
| Max. Negotiated Rate |
$3,150.15 |
| Rate for Payer: Aetna Commercial |
$2,975.14
|
| Rate for Payer: Aetna Medicare |
$910.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,093.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,093.80
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$875.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.38
|
| Rate for Payer: BCN Commercial |
$2,721.38
|
| Rate for Payer: BCN Medicare Advantage |
$875.04
|
| Rate for Payer: Cash Price |
$2,800.14
|
| Rate for Payer: Cash Price |
$2,800.14
|
| Rate for Payer: Cofinity Commercial |
$3,010.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.04
|
| Rate for Payer: Healthscope Commercial |
$3,150.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,625.13
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$918.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,006.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.14
|
| Rate for Payer: PACE Senior Care Partners |
$831.29
|
| Rate for Payer: PACE SWMI |
$875.04
|
| Rate for Payer: PHP Commercial |
$2,975.14
|
| Rate for Payer: PHP Medicare Advantage |
$875.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.15
|
| Rate for Payer: Priority Health Medicare |
$875.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,134.75
|
| Rate for Payer: Railroad Medicare Medicare |
$875.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.15
|
| Rate for Payer: UHC Core |
$2,922.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.04
|
| Rate for Payer: UHC Medicare Advantage |
$901.29
|
| Rate for Payer: VA VA |
$875.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,625.13
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,500.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,134.75 |
| Max. Negotiated Rate |
$3,150.15 |
| Rate for Payer: Aetna Commercial |
$2,975.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,704.93
|
| Rate for Payer: BCN Commercial |
$2,704.93
|
| Rate for Payer: Cash Price |
$2,800.14
|
| Rate for Payer: Cofinity Commercial |
$3,010.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.14
|
| Rate for Payer: Healthscope Commercial |
$3,150.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,625.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.14
|
| Rate for Payer: PHP Commercial |
$2,975.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,134.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.15
|
| Rate for Payer: UHC Core |
$2,922.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,625.13
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,184.66
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.36 |
| Max. Negotiated Rate |
$1,066.19 |
| Rate for Payer: Aetna Commercial |
$1,006.96
|
| Rate for Payer: Aetna Medicare |
$308.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.21
|
| Rate for Payer: BCBS Complete |
$629.53
|
| Rate for Payer: BCBS MAPPO |
$296.16
|
| Rate for Payer: BCBS Trust/PPO |
$921.07
|
| Rate for Payer: BCN Commercial |
$921.07
|
| Rate for Payer: BCN Medicare Advantage |
$296.16
|
| Rate for Payer: Cash Price |
$947.73
|
| Rate for Payer: Cash Price |
$947.73
|
| Rate for Payer: Cofinity Commercial |
$1,018.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$947.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.16
|
| Rate for Payer: Healthscope Commercial |
$1,066.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.50
|
| Rate for Payer: Mclaren Medicaid |
$599.55
|
| Rate for Payer: Meridian Medicaid |
$629.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$310.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,006.96
|
| Rate for Payer: PACE Senior Care Partners |
$281.36
|
| Rate for Payer: PACE SWMI |
$296.16
|
| Rate for Payer: PHP Commercial |
$1,006.96
|
| Rate for Payer: PHP Medicare Advantage |
$296.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.65
|
| Rate for Payer: Priority Health Medicare |
$296.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$722.52
|
| Rate for Payer: Railroad Medicare Medicare |
$296.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.50
|
| Rate for Payer: UHC Core |
$989.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.16
|
| Rate for Payer: UHC Medicare Advantage |
$305.05
|
| Rate for Payer: VA VA |
$296.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.50
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,184.66
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$722.52 |
| Max. Negotiated Rate |
$1,066.19 |
| Rate for Payer: Aetna Commercial |
$1,006.96
|
| Rate for Payer: BCBS Trust/PPO |
$915.51
|
| Rate for Payer: BCN Commercial |
$915.51
|
| Rate for Payer: Cash Price |
$947.73
|
| Rate for Payer: Cofinity Commercial |
$1,018.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$947.73
|
| Rate for Payer: Healthscope Commercial |
$1,066.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,006.96
|
| Rate for Payer: PHP Commercial |
$1,006.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$722.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.50
|
| Rate for Payer: UHC Core |
$989.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.50
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$158.20
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$96.49 |
| Max. Negotiated Rate |
$142.38 |
| Rate for Payer: Aetna Commercial |
$134.47
|
| Rate for Payer: BCBS Trust/PPO |
$122.26
|
| Rate for Payer: BCN Commercial |
$122.26
|
| Rate for Payer: Cash Price |
$126.56
|
| Rate for Payer: Cofinity Commercial |
$136.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.56
|
| Rate for Payer: Healthscope Commercial |
$142.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.47
|
| Rate for Payer: PHP Commercial |
$134.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.22
|
| Rate for Payer: UHC Core |
$132.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.65
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$158.20
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$142.38 |
| Rate for Payer: Aetna Commercial |
$134.47
|
| Rate for Payer: Aetna Medicare |
$41.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.44
|
| Rate for Payer: BCBS Complete |
$26.30
|
| Rate for Payer: BCBS MAPPO |
$39.55
|
| Rate for Payer: BCBS Trust/PPO |
$123.00
|
| Rate for Payer: BCN Commercial |
$123.00
|
| Rate for Payer: BCN Medicare Advantage |
$39.55
|
| Rate for Payer: Cash Price |
$126.56
|
| Rate for Payer: Cash Price |
$126.56
|
| Rate for Payer: Cofinity Commercial |
$136.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.55
|
| Rate for Payer: Healthscope Commercial |
$142.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.65
|
| Rate for Payer: Mclaren Medicaid |
$25.05
|
| Rate for Payer: Meridian Medicaid |
$26.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.47
|
| Rate for Payer: PACE Senior Care Partners |
$37.57
|
| Rate for Payer: PACE SWMI |
$39.55
|
| Rate for Payer: PHP Commercial |
$134.47
|
| Rate for Payer: PHP Medicare Advantage |
$39.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.63
|
| Rate for Payer: Priority Health Medicare |
$39.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.49
|
| Rate for Payer: Railroad Medicare Medicare |
$39.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.22
|
| Rate for Payer: UHC Core |
$132.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.55
|
| Rate for Payer: UHC Medicare Advantage |
$40.74
|
| Rate for Payer: VA VA |
$39.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.65
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: BCBS Complete |
$18.26
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$17.39
|
| Rate for Payer: Meridian Medicaid |
$18.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.97 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: BCBS Trust/PPO |
$41.78
|
| Rate for Payer: BCN Commercial |
$41.78
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
