|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
IP
|
$102.44
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.59 |
| Max. Negotiated Rate |
$92.20 |
| Rate for Payer: Aetna Commercial |
$87.07
|
| Rate for Payer: BCBS Trust/PPO |
$83.62
|
| Rate for Payer: BCN Commercial |
$79.17
|
| Rate for Payer: Cash Price |
$81.95
|
| Rate for Payer: Cofinity Commercial |
$88.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.95
|
| Rate for Payer: Healthscope Commercial |
$92.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.07
|
| Rate for Payer: Nomi Health Commercial |
$84.00
|
| Rate for Payer: PHP Commercial |
$87.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.59
|
| Rate for Payer: Priority Health HMO/PPO |
$89.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.15
|
| Rate for Payer: UHC Core |
$85.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.83
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
OP
|
$132.76
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.53 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: Aetna Medicare |
$34.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.49
|
| Rate for Payer: BCBS Complete |
$53.10
|
| Rate for Payer: BCBS MAPPO |
$33.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.14
|
| Rate for Payer: BCN Commercial |
$103.22
|
| Rate for Payer: BCN Medicare Advantage |
$33.19
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.19
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PACE Senior Care Partners |
$31.53
|
| Rate for Payer: PACE SWMI |
$33.19
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: PHP Medicare Advantage |
$33.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Medicare |
$33.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: Railroad Medicare Medicare |
$33.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.19
|
| Rate for Payer: UHC Exchange |
$33.19
|
| Rate for Payer: UHC Medicare Advantage |
$33.19
|
| Rate for Payer: VA VA |
$33.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
IP
|
$132.76
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$86.29 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: BCBS Trust/PPO |
$108.37
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
OP
|
$78.54
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$31.42
|
| Rate for Payer: BCBS MAPPO |
$19.64
|
| Rate for Payer: BCBS Trust/PPO |
$64.57
|
| Rate for Payer: BCN Commercial |
$61.06
|
| Rate for Payer: BCN Medicare Advantage |
$19.64
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.64
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.76
|
| Rate for Payer: Nomi Health Commercial |
$64.40
|
| Rate for Payer: PACE Senior Care Partners |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.64
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: PHP Medicare Advantage |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.05
|
| Rate for Payer: Priority Health HMO/PPO |
$68.33
|
| Rate for Payer: Priority Health Medicare |
$19.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.62
|
| Rate for Payer: Railroad Medicare Medicare |
$19.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.64
|
| Rate for Payer: UHC Exchange |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.64
|
| Rate for Payer: VA VA |
$19.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.91
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
IP
|
$78.54
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: BCBS Trust/PPO |
$64.11
|
| Rate for Payer: BCN Commercial |
$60.70
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.76
|
| Rate for Payer: Nomi Health Commercial |
$64.40
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.05
|
| Rate for Payer: Priority Health HMO/PPO |
$68.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.91
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.32 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$23.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.05
|
| Rate for Payer: BCBS Complete |
$35.90
|
| Rate for Payer: BCBS MAPPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$73.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$22.44
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.44
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PACE Senior Care Partners |
$21.32
|
| Rate for Payer: PACE SWMI |
$22.44
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Medicare |
$22.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.44
|
| Rate for Payer: UHC Exchange |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$22.44
|
| Rate for Payer: VA VA |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: BCBS Trust/PPO |
$73.27
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
OP
|
$217.40
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$184.79
|
| Rate for Payer: Aetna Medicare |
$56.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.94
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$178.72
|
| Rate for Payer: BCN Commercial |
$169.03
|
| Rate for Payer: BCN Medicare Advantage |
$54.35
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.35
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.05
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.07
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.79
|
| Rate for Payer: Nomi Health Commercial |
$178.27
|
| Rate for Payer: PACE Senior Care Partners |
$51.63
|
| Rate for Payer: PACE SWMI |
$54.35
|
| Rate for Payer: PHP Commercial |
$184.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.31
|
| Rate for Payer: Priority Health HMO/PPO |
$189.14
|
| Rate for Payer: Priority Health Medicare |
$54.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.66
|
| Rate for Payer: Railroad Medicare Medicare |
$54.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.31
|
| Rate for Payer: UHC Core |
$181.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.35
|
| Rate for Payer: UHC Exchange |
$54.35
|
| Rate for Payer: UHC Medicare Advantage |
$54.35
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$54.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.05
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
IP
|
$217.40
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$141.31 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$184.79
|
| Rate for Payer: BCBS Trust/PPO |
$177.46
|
| Rate for Payer: BCN Commercial |
$168.01
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.92
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.79
|
| Rate for Payer: Nomi Health Commercial |
$178.27
|
| Rate for Payer: PHP Commercial |
$184.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.31
|
| Rate for Payer: Priority Health HMO/PPO |
$189.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.31
|
| Rate for Payer: UHC Core |
$181.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.05
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$19.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.73
|
| Rate for Payer: BCBS Complete |
$28.31
|
| Rate for Payer: BCBS MAPPO |
$18.99
|
| Rate for Payer: BCBS Trust/PPO |
$62.44
|
| Rate for Payer: BCN Commercial |
$59.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.99
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Mclaren Medicaid |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.94
|
| Rate for Payer: Meridian Medicaid |
$28.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PACE Senior Care Partners |
$18.04
|
| Rate for Payer: PACE SWMI |
$18.99
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$19.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.99
|
| Rate for Payer: UHC Exchange |
$18.99
|
| Rate for Payer: UHC Medicare Advantage |
$18.99
|
| Rate for Payer: UHCCP Medicaid |
$26.96
|
| Rate for Payer: VA VA |
$18.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: BCBS Trust/PPO |
$62.00
|
| Rate for Payer: BCN Commercial |
$58.69
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$21.71
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$7.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.78
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$23.09
|
| Rate for Payer: BCN Commercial |
$21.84
|
| Rate for Payer: BCN Medicare Advantage |
$7.02
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.02
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.37
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PACE Senior Care Partners |
$6.67
|
| Rate for Payer: PACE SWMI |
$7.02
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Medicare |
$7.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.02
|
| Rate for Payer: UHC Exchange |
$7.02
|
| Rate for Payer: UHC Medicare Advantage |
$7.02
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$7.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: BCBS Trust/PPO |
$71.69
|
| Rate for Payer: BCN Commercial |
$67.87
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Medicare |
$22.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.44
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$21.95
|
| Rate for Payer: BCBS Trust/PPO |
$72.20
|
| Rate for Payer: BCN Commercial |
$68.28
|
| Rate for Payer: BCN Medicare Advantage |
$21.95
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.95
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.05
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PACE Senior Care Partners |
$20.86
|
| Rate for Payer: PACE SWMI |
$21.95
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Medicare |
$22.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.95
|
| Rate for Payer: UHC Exchange |
$21.95
|
| Rate for Payer: UHC Medicare Advantage |
$21.95
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
OP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$748.12 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna Medicare |
$819.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$984.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$984.38
|
| Rate for Payer: BCBS Complete |
$1,260.00
|
| Rate for Payer: BCBS MAPPO |
$787.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,589.61
|
| Rate for Payer: BCN Commercial |
$2,449.12
|
| Rate for Payer: BCN Medicare Advantage |
$787.50
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.50
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$905.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: PACE Senior Care Partners |
$748.12
|
| Rate for Payer: PACE SWMI |
$787.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: PHP Medicare Advantage |
$787.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Medicare |
$795.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,110.50
|
| Rate for Payer: Railroad Medicare Medicare |
$787.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.50
|
| Rate for Payer: UHC Exchange |
$787.50
|
| Rate for Payer: UHC Medicare Advantage |
$787.50
|
| Rate for Payer: VA VA |
$787.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,047.50 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.34
|
| Rate for Payer: BCN Commercial |
$2,434.32
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,110.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
IP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,592.20 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,255.40
|
| Rate for Payer: BCN Commercial |
$3,081.93
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,671.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
OP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.15 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna Medicare |
$1,036.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.25
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: BCBS MAPPO |
$997.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,278.53
|
| Rate for Payer: BCN Commercial |
$3,100.67
|
| Rate for Payer: BCN Medicare Advantage |
$997.00
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.00
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: PACE Senior Care Partners |
$947.15
|
| Rate for Payer: PACE SWMI |
$997.00
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: PHP Medicare Advantage |
$997.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Medicare |
$1,006.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,671.96
|
| Rate for Payer: Railroad Medicare Medicare |
$997.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$997.00
|
| Rate for Payer: UHC Exchange |
$997.00
|
| Rate for Payer: UHC Medicare Advantage |
$997.00
|
| Rate for Payer: VA VA |
$997.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
OP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,097.25 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna Medicare |
$1,201.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,443.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,443.75
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: BCBS MAPPO |
$1,155.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,798.10
|
| Rate for Payer: BCN Commercial |
$3,592.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,212.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,097.25
|
| Rate for Payer: PACE SWMI |
$1,155.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,019.40
|
| Rate for Payer: Priority Health Medicare |
$1,166.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,095.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,065.60
|
| Rate for Payer: UHC Core |
$3,857.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.00
|
| Rate for Payer: UHC Exchange |
$1,155.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.00
|
| Rate for Payer: VA VA |
$1,155.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
IP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,003.00 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,771.31
|
| Rate for Payer: BCN Commercial |
$3,570.34
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: Nomi Health Commercial |
$3,788.40
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,019.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,095.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,065.60
|
| Rate for Payer: UHC Core |
$3,857.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
IP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,112.20 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,908.44
|
| Rate for Payer: BCN Commercial |
$3,700.17
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health HMO/PPO |
$4,165.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,207.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,213.44
|
| Rate for Payer: UHC Core |
$3,997.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
OP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,137.15 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna Medicare |
$1,244.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,496.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,496.25
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: BCBS MAPPO |
$1,197.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,936.21
|
| Rate for Payer: BCN Commercial |
$3,722.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,197.00
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,197.00
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,256.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,376.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: Nomi Health Commercial |
$3,926.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,137.15
|
| Rate for Payer: PACE SWMI |
$1,197.00
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,197.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health HMO/PPO |
$4,165.56
|
| Rate for Payer: Priority Health Medicare |
$1,208.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,207.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,197.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,213.44
|
| Rate for Payer: UHC Core |
$3,997.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,197.00
|
| Rate for Payer: UHC Exchange |
$1,197.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,197.00
|
| Rate for Payer: VA VA |
$1,197.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
OP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$265.76 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna Medicare |
$290.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.69
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS MAPPO |
$279.75
|
| Rate for Payer: BCBS Trust/PPO |
$919.93
|
| Rate for Payer: BCN Commercial |
$870.02
|
| Rate for Payer: BCN Medicare Advantage |
$279.75
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.75
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: PACE Senior Care Partners |
$265.76
|
| Rate for Payer: PACE SWMI |
$279.75
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: PHP Medicare Advantage |
$279.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO |
$973.53
|
| Rate for Payer: Priority Health Medicare |
$282.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.73
|
| Rate for Payer: Railroad Medicare Medicare |
$279.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.72
|
| Rate for Payer: UHC Core |
$934.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.75
|
| Rate for Payer: UHC Exchange |
$279.75
|
| Rate for Payer: UHC Medicare Advantage |
$279.75
|
| Rate for Payer: VA VA |
$279.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
IP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$727.35 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: BCBS Trust/PPO |
$913.44
|
| Rate for Payer: BCN Commercial |
$864.76
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: Nomi Health Commercial |
$917.58
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health HMO/PPO |
$973.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.72
|
| Rate for Payer: UHC Core |
$934.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
