|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 41
|
Facility
|
OP
|
$4,100.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.75 |
| Max. Negotiated Rate |
$3,690.00 |
| Rate for Payer: Aetna Commercial |
$3,485.00
|
| Rate for Payer: Aetna Medicare |
$1,066.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,281.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,281.25
|
| Rate for Payer: BCBS Complete |
$1,640.00
|
| Rate for Payer: BCBS MAPPO |
$1,025.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,370.61
|
| Rate for Payer: BCN Commercial |
$3,187.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.00
|
| Rate for Payer: Cash Price |
$3,280.00
|
| Rate for Payer: Cofinity Commercial |
$3,526.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,280.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.00
|
| Rate for Payer: Healthscope Commercial |
$3,690.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,075.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,178.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,485.00
|
| Rate for Payer: Nomi Health Commercial |
$3,362.00
|
| Rate for Payer: PACE Senior Care Partners |
$973.75
|
| Rate for Payer: PACE SWMI |
$1,025.00
|
| Rate for Payer: PHP Commercial |
$3,485.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,665.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,567.00
|
| Rate for Payer: Priority Health Medicare |
$1,035.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,747.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,025.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,608.00
|
| Rate for Payer: UHC Core |
$3,423.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.00
|
| Rate for Payer: UHC Exchange |
$1,025.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.00
|
| Rate for Payer: VA VA |
$1,025.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,075.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 45
|
Facility
|
OP
|
$4,681.80
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,111.93 |
| Max. Negotiated Rate |
$4,213.62 |
| Rate for Payer: Aetna Commercial |
$3,979.53
|
| Rate for Payer: Aetna Medicare |
$1,217.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,463.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,463.06
|
| Rate for Payer: BCBS Complete |
$1,872.72
|
| Rate for Payer: BCBS MAPPO |
$1,170.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,848.91
|
| Rate for Payer: BCN Commercial |
$3,640.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,170.45
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Commercial |
$4,026.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,170.45
|
| Rate for Payer: Healthscope Commercial |
$4,213.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,511.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,228.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,346.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,979.53
|
| Rate for Payer: Nomi Health Commercial |
$3,839.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,111.93
|
| Rate for Payer: PACE SWMI |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$3,979.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,043.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,073.17
|
| Rate for Payer: Priority Health Medicare |
$1,182.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,136.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,170.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,119.98
|
| Rate for Payer: UHC Core |
$3,909.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,170.45
|
| Rate for Payer: UHC Exchange |
$1,170.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,170.45
|
| Rate for Payer: VA VA |
$1,170.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,511.35
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 45
|
Facility
|
IP
|
$4,681.80
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,043.17 |
| Max. Negotiated Rate |
$4,213.62 |
| Rate for Payer: Aetna Commercial |
$3,979.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,821.75
|
| Rate for Payer: BCN Commercial |
$3,618.10
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Commercial |
$4,026.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Healthscope Commercial |
$4,213.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,511.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,979.53
|
| Rate for Payer: Nomi Health Commercial |
$3,839.08
|
| Rate for Payer: PHP Commercial |
$3,979.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,043.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,073.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,136.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,119.98
|
| Rate for Payer: UHC Core |
$3,909.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,511.35
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 62
|
Facility
|
OP
|
$6,374.09
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,513.85 |
| Max. Negotiated Rate |
$5,736.68 |
| Rate for Payer: Aetna Commercial |
$5,417.98
|
| Rate for Payer: Aetna Medicare |
$1,657.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,991.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,991.90
|
| Rate for Payer: BCBS Complete |
$2,549.64
|
| Rate for Payer: BCBS MAPPO |
$1,593.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,240.14
|
| Rate for Payer: BCN Commercial |
$4,955.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,593.52
|
| Rate for Payer: Cash Price |
$5,099.27
|
| Rate for Payer: Cofinity Commercial |
$5,481.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,099.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,593.52
|
| Rate for Payer: Healthscope Commercial |
$5,736.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,780.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,673.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,832.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,417.98
|
| Rate for Payer: Nomi Health Commercial |
$5,226.75
|
| Rate for Payer: PACE Senior Care Partners |
$1,513.85
|
| Rate for Payer: PACE SWMI |
$1,593.52
|
| Rate for Payer: PHP Commercial |
$5,417.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,593.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,143.16
|
| Rate for Payer: Priority Health HMO/PPO |
$5,545.46
|
| Rate for Payer: Priority Health Medicare |
$1,609.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,270.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,593.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,609.20
|
| Rate for Payer: UHC Core |
$5,322.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,593.52
|
| Rate for Payer: UHC Exchange |
$1,593.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,593.52
|
| Rate for Payer: VA VA |
$1,593.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,780.57
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 62
|
Facility
|
IP
|
$6,374.09
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,143.16 |
| Max. Negotiated Rate |
$5,736.68 |
| Rate for Payer: Aetna Commercial |
$5,417.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,203.17
|
| Rate for Payer: BCN Commercial |
$4,925.90
|
| Rate for Payer: Cash Price |
$5,099.27
|
| Rate for Payer: Cofinity Commercial |
$5,481.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,099.27
|
| Rate for Payer: Healthscope Commercial |
$5,736.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,780.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,417.98
|
| Rate for Payer: Nomi Health Commercial |
$5,226.75
|
| Rate for Payer: PHP Commercial |
$5,417.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,143.16
|
| Rate for Payer: Priority Health HMO/PPO |
$5,545.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,270.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,609.20
|
| Rate for Payer: UHC Core |
$5,322.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,780.57
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 73
|
Facility
|
OP
|
$7,300.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,733.75 |
| Max. Negotiated Rate |
$6,570.00 |
| Rate for Payer: Aetna Commercial |
$6,205.00
|
| Rate for Payer: Aetna Medicare |
$1,898.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,281.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,281.25
|
| Rate for Payer: BCBS Complete |
$2,920.00
|
| Rate for Payer: BCBS MAPPO |
$1,825.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,001.33
|
| Rate for Payer: BCN Commercial |
$5,675.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,825.00
|
| Rate for Payer: Cash Price |
$5,840.00
|
| Rate for Payer: Cofinity Commercial |
$6,278.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,840.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,825.00
|
| Rate for Payer: Healthscope Commercial |
$6,570.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,475.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,916.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,098.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,205.00
|
| Rate for Payer: Nomi Health Commercial |
$5,986.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,733.75
|
| Rate for Payer: PACE SWMI |
$1,825.00
|
| Rate for Payer: PHP Commercial |
$6,205.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,825.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.00
|
| Rate for Payer: Priority Health HMO/PPO |
$6,351.00
|
| Rate for Payer: Priority Health Medicare |
$1,843.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,891.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,825.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,424.00
|
| Rate for Payer: UHC Core |
$6,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,825.00
|
| Rate for Payer: UHC Exchange |
$1,825.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,825.00
|
| Rate for Payer: VA VA |
$1,825.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,475.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS 3D OR VECTOR MAPPING LEVEL 73
|
Facility
|
IP
|
$7,300.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200378
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,745.00 |
| Max. Negotiated Rate |
$6,570.00 |
| Rate for Payer: Aetna Commercial |
$6,205.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,958.99
|
| Rate for Payer: BCN Commercial |
$5,641.44
|
| Rate for Payer: Cash Price |
$5,840.00
|
| Rate for Payer: Cofinity Commercial |
$6,278.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,840.00
|
| Rate for Payer: Healthscope Commercial |
$6,570.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,475.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,205.00
|
| Rate for Payer: Nomi Health Commercial |
$5,986.00
|
| Rate for Payer: PHP Commercial |
$6,205.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.00
|
| Rate for Payer: Priority Health HMO/PPO |
$6,351.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,891.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,424.00
|
| Rate for Payer: UHC Core |
$6,095.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,475.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 66
|
Facility
|
IP
|
$6,691.20
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,349.28 |
| Max. Negotiated Rate |
$6,022.08 |
| Rate for Payer: Aetna Commercial |
$5,687.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,462.03
|
| Rate for Payer: BCN Commercial |
$5,170.96
|
| Rate for Payer: Cash Price |
$5,352.96
|
| Rate for Payer: Cofinity Commercial |
$5,754.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,352.96
|
| Rate for Payer: Healthscope Commercial |
$6,022.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,018.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,687.52
|
| Rate for Payer: Nomi Health Commercial |
$5,486.78
|
| Rate for Payer: PHP Commercial |
$5,687.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,349.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,821.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,483.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,888.26
|
| Rate for Payer: UHC Core |
$5,587.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,018.40
|
|
|
HC ELECTROPHYSIOLOGY CATHS DIAG/ABLAT LEVEL 66
|
Facility
|
OP
|
$6,691.20
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,589.16 |
| Max. Negotiated Rate |
$6,022.08 |
| Rate for Payer: Aetna Commercial |
$5,687.52
|
| Rate for Payer: Aetna Medicare |
$1,739.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,091.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,091.00
|
| Rate for Payer: BCBS Complete |
$2,676.48
|
| Rate for Payer: BCBS MAPPO |
$1,672.80
|
| Rate for Payer: BCBS Trust/PPO |
$5,500.84
|
| Rate for Payer: BCN Commercial |
$5,202.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,672.80
|
| Rate for Payer: Cash Price |
$5,352.96
|
| Rate for Payer: Cofinity Commercial |
$5,754.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,352.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$6,022.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,018.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,756.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,923.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,687.52
|
| Rate for Payer: Nomi Health Commercial |
$5,486.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,589.16
|
| Rate for Payer: PACE SWMI |
$1,672.80
|
| Rate for Payer: PHP Commercial |
$5,687.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,672.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,349.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,821.34
|
| Rate for Payer: Priority Health Medicare |
$1,689.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,483.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,672.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,888.26
|
| Rate for Payer: UHC Core |
$5,587.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,672.80
|
| Rate for Payer: UHC Exchange |
$1,672.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,672.80
|
| Rate for Payer: VA VA |
$1,672.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,018.40
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 12
|
Facility
|
IP
|
$1,232.87
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
27200325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$801.37 |
| Max. Negotiated Rate |
$1,109.58 |
| Rate for Payer: Aetna Commercial |
$1,047.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.39
|
| Rate for Payer: BCN Commercial |
$952.76
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,109.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: PHP Commercial |
$1,047.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.65
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 12
|
Facility
|
OP
|
$1,232.87
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
27200325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.81 |
| Max. Negotiated Rate |
$1,109.58 |
| Rate for Payer: Aetna Commercial |
$1,047.94
|
| Rate for Payer: Aetna Medicare |
$320.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.27
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS MAPPO |
$308.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.54
|
| Rate for Payer: BCN Commercial |
$958.56
|
| Rate for Payer: BCN Medicare Advantage |
$308.22
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.22
|
| Rate for Payer: Healthscope Commercial |
$1,109.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: PACE Senior Care Partners |
$292.81
|
| Rate for Payer: PACE SWMI |
$308.22
|
| Rate for Payer: PHP Commercial |
$1,047.94
|
| Rate for Payer: PHP Medicare Advantage |
$308.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.60
|
| Rate for Payer: Priority Health Medicare |
$311.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.02
|
| Rate for Payer: Railroad Medicare Medicare |
$308.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.22
|
| Rate for Payer: UHC Exchange |
$308.22
|
| Rate for Payer: UHC Medicare Advantage |
$308.22
|
| Rate for Payer: VA VA |
$308.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.65
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
IP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,866.35 |
| Max. Negotiated Rate |
$2,584.17 |
| Rate for Payer: Aetna Commercial |
$2,440.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,343.84
|
| Rate for Payer: BCN Commercial |
$2,218.94
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Commercial |
$2,469.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Healthscope Commercial |
$2,584.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,153.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: PHP Commercial |
$2,440.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,498.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,923.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,526.74
|
| Rate for Payer: UHC Core |
$2,397.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,153.47
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
OP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$681.93 |
| Max. Negotiated Rate |
$2,584.17 |
| Rate for Payer: Aetna Commercial |
$2,440.61
|
| Rate for Payer: Aetna Medicare |
$746.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$897.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$897.28
|
| Rate for Payer: BCBS Complete |
$1,148.52
|
| Rate for Payer: BCBS MAPPO |
$717.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,360.50
|
| Rate for Payer: BCN Commercial |
$2,232.44
|
| Rate for Payer: BCN Medicare Advantage |
$717.83
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Commercial |
$2,469.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.83
|
| Rate for Payer: Healthscope Commercial |
$2,584.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,153.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$753.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Nomi Health Commercial |
$2,354.47
|
| Rate for Payer: PACE Senior Care Partners |
$681.93
|
| Rate for Payer: PACE SWMI |
$717.83
|
| Rate for Payer: PHP Commercial |
$2,440.61
|
| Rate for Payer: PHP Medicare Advantage |
$717.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,498.03
|
| Rate for Payer: Priority Health Medicare |
$725.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,923.77
|
| Rate for Payer: Railroad Medicare Medicare |
$717.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,526.74
|
| Rate for Payer: UHC Core |
$2,397.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.83
|
| Rate for Payer: UHC Exchange |
$717.83
|
| Rate for Payer: UHC Medicare Advantage |
$717.83
|
| Rate for Payer: VA VA |
$717.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,153.47
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
OP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$775.20 |
| Max. Negotiated Rate |
$2,937.60 |
| Rate for Payer: Aetna Commercial |
$2,774.40
|
| Rate for Payer: Aetna Medicare |
$848.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,020.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,020.00
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: BCBS MAPPO |
$816.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.33
|
| Rate for Payer: BCN Commercial |
$2,537.76
|
| Rate for Payer: BCN Medicare Advantage |
$816.00
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Commercial |
$2,807.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$2,937.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,448.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$856.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$938.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Nomi Health Commercial |
$2,676.48
|
| Rate for Payer: PACE Senior Care Partners |
$775.20
|
| Rate for Payer: PACE SWMI |
$816.00
|
| Rate for Payer: PHP Commercial |
$2,774.40
|
| Rate for Payer: PHP Medicare Advantage |
$816.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,839.68
|
| Rate for Payer: Priority Health Medicare |
$824.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,186.88
|
| Rate for Payer: Railroad Medicare Medicare |
$816.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,872.32
|
| Rate for Payer: UHC Core |
$2,725.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.00
|
| Rate for Payer: UHC Exchange |
$816.00
|
| Rate for Payer: UHC Medicare Advantage |
$816.00
|
| Rate for Payer: VA VA |
$816.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,448.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
IP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,121.60 |
| Max. Negotiated Rate |
$2,937.60 |
| Rate for Payer: Aetna Commercial |
$2,774.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,664.40
|
| Rate for Payer: BCN Commercial |
$2,522.42
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Commercial |
$2,807.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Healthscope Commercial |
$2,937.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,448.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Nomi Health Commercial |
$2,676.48
|
| Rate for Payer: PHP Commercial |
$2,774.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,839.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,186.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,872.32
|
| Rate for Payer: UHC Core |
$2,725.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,448.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
OP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.52 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna Medicare |
$179.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.16
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS MAPPO |
$172.12
|
| Rate for Payer: BCBS Trust/PPO |
$566.02
|
| Rate for Payer: BCN Commercial |
$535.31
|
| Rate for Payer: BCN Medicare Advantage |
$172.12
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.12
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: PACE Senior Care Partners |
$163.52
|
| Rate for Payer: PACE SWMI |
$172.12
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: PHP Medicare Advantage |
$172.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health HMO/PPO |
$599.00
|
| Rate for Payer: Priority Health Medicare |
$173.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.30
|
| Rate for Payer: Railroad Medicare Medicare |
$172.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.88
|
| Rate for Payer: UHC Core |
$574.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.12
|
| Rate for Payer: UHC Exchange |
$172.12
|
| Rate for Payer: UHC Medicare Advantage |
$172.12
|
| Rate for Payer: VA VA |
$172.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
IP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$447.52 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: BCBS Trust/PPO |
$562.02
|
| Rate for Payer: BCN Commercial |
$532.07
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health HMO/PPO |
$599.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.88
|
| Rate for Payer: UHC Core |
$574.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
OP
|
$4,792.38
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,138.19 |
| Max. Negotiated Rate |
$4,313.14 |
| Rate for Payer: Aetna Commercial |
$4,073.52
|
| Rate for Payer: Aetna Medicare |
$1,246.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,497.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,497.62
|
| Rate for Payer: BCBS Complete |
$1,916.95
|
| Rate for Payer: BCBS MAPPO |
$1,198.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,939.82
|
| Rate for Payer: BCN Commercial |
$3,726.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,198.10
|
| Rate for Payer: Cash Price |
$3,833.90
|
| Rate for Payer: Cofinity Commercial |
$4,121.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,833.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,198.10
|
| Rate for Payer: Healthscope Commercial |
$4,313.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,594.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,258.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,377.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,073.52
|
| Rate for Payer: Nomi Health Commercial |
$3,929.75
|
| Rate for Payer: PACE Senior Care Partners |
$1,138.19
|
| Rate for Payer: PACE SWMI |
$1,198.10
|
| Rate for Payer: PHP Commercial |
$4,073.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,198.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.05
|
| Rate for Payer: Priority Health HMO/PPO |
$4,169.37
|
| Rate for Payer: Priority Health Medicare |
$1,210.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,210.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,198.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,217.29
|
| Rate for Payer: UHC Core |
$4,001.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,198.10
|
| Rate for Payer: UHC Exchange |
$1,198.10
|
| Rate for Payer: UHC Medicare Advantage |
$1,198.10
|
| Rate for Payer: VA VA |
$1,198.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,594.28
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
IP
|
$4,792.38
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,115.05 |
| Max. Negotiated Rate |
$4,313.14 |
| Rate for Payer: Aetna Commercial |
$4,073.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,912.02
|
| Rate for Payer: BCN Commercial |
$3,703.55
|
| Rate for Payer: Cash Price |
$3,833.90
|
| Rate for Payer: Cofinity Commercial |
$4,121.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,833.90
|
| Rate for Payer: Healthscope Commercial |
$4,313.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,594.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,073.52
|
| Rate for Payer: Nomi Health Commercial |
$3,929.75
|
| Rate for Payer: PHP Commercial |
$4,073.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,115.05
|
| Rate for Payer: Priority Health HMO/PPO |
$4,169.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,210.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,217.29
|
| Rate for Payer: UHC Core |
$4,001.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,594.28
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
OP
|
$266.93
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$240.24 |
| Rate for Payer: Aetna Commercial |
$226.89
|
| Rate for Payer: Aetna Medicare |
$69.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.42
|
| Rate for Payer: BCBS Complete |
$106.77
|
| Rate for Payer: BCBS MAPPO |
$66.73
|
| Rate for Payer: BCBS Trust/PPO |
$219.44
|
| Rate for Payer: BCN Commercial |
$207.54
|
| Rate for Payer: BCN Medicare Advantage |
$66.73
|
| Rate for Payer: Cash Price |
$213.54
|
| Rate for Payer: Cofinity Commercial |
$229.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.73
|
| Rate for Payer: Healthscope Commercial |
$240.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.89
|
| Rate for Payer: Nomi Health Commercial |
$218.88
|
| Rate for Payer: PACE Senior Care Partners |
$63.40
|
| Rate for Payer: PACE SWMI |
$66.73
|
| Rate for Payer: PHP Commercial |
$226.89
|
| Rate for Payer: PHP Medicare Advantage |
$66.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO |
$232.23
|
| Rate for Payer: Priority Health Medicare |
$67.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.84
|
| Rate for Payer: Railroad Medicare Medicare |
$66.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.90
|
| Rate for Payer: UHC Core |
$222.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.73
|
| Rate for Payer: UHC Exchange |
$66.73
|
| Rate for Payer: UHC Medicare Advantage |
$66.73
|
| Rate for Payer: VA VA |
$66.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.20
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
IP
|
$266.93
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$173.50 |
| Max. Negotiated Rate |
$240.24 |
| Rate for Payer: Aetna Commercial |
$226.89
|
| Rate for Payer: BCBS Trust/PPO |
$217.89
|
| Rate for Payer: BCN Commercial |
$206.28
|
| Rate for Payer: Cash Price |
$213.54
|
| Rate for Payer: Cofinity Commercial |
$229.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.54
|
| Rate for Payer: Healthscope Commercial |
$240.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.89
|
| Rate for Payer: Nomi Health Commercial |
$218.88
|
| Rate for Payer: PHP Commercial |
$226.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO |
$232.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.90
|
| Rate for Payer: UHC Core |
$222.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.20
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
IP
|
$27,014.28
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,559.28 |
| Max. Negotiated Rate |
$24,312.85 |
| Rate for Payer: Aetna Commercial |
$22,962.14
|
| Rate for Payer: BCBS Trust/PPO |
$22,051.76
|
| Rate for Payer: BCN Commercial |
$20,876.64
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cofinity Commercial |
$23,232.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,611.42
|
| Rate for Payer: Healthscope Commercial |
$24,312.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,260.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,962.14
|
| Rate for Payer: Nomi Health Commercial |
$22,151.71
|
| Rate for Payer: PHP Commercial |
$22,962.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,559.28
|
| Rate for Payer: Priority Health HMO/PPO |
$23,502.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,099.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,772.57
|
| Rate for Payer: UHC Core |
$22,556.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,260.71
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
OP
|
$27,014.28
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,486.20 |
| Max. Negotiated Rate |
$24,312.85 |
| Rate for Payer: Aetna Commercial |
$22,962.14
|
| Rate for Payer: Aetna Medicare |
$7,023.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,441.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,441.96
|
| Rate for Payer: BCBS Complete |
$5,760.89
|
| Rate for Payer: BCBS MAPPO |
$6,753.57
|
| Rate for Payer: BCBS Trust/PPO |
$22,208.44
|
| Rate for Payer: BCN Commercial |
$21,003.60
|
| Rate for Payer: BCN Medicare Advantage |
$6,753.57
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cash Price |
$21,611.42
|
| Rate for Payer: Cofinity Commercial |
$23,232.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,611.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,753.57
|
| Rate for Payer: Healthscope Commercial |
$24,312.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,260.71
|
| Rate for Payer: Mclaren Medicaid |
$5,486.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,091.25
|
| Rate for Payer: Meridian Medicaid |
$5,760.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,766.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,962.14
|
| Rate for Payer: Nomi Health Commercial |
$22,151.71
|
| Rate for Payer: PACE Senior Care Partners |
$6,415.89
|
| Rate for Payer: PACE SWMI |
$6,753.57
|
| Rate for Payer: PHP Commercial |
$22,962.14
|
| Rate for Payer: PHP Medicare Advantage |
$6,753.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,486.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,559.28
|
| Rate for Payer: Priority Health HMO/PPO |
$23,502.42
|
| Rate for Payer: Priority Health Medicare |
$6,821.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,099.57
|
| Rate for Payer: Railroad Medicare Medicare |
$6,753.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,772.57
|
| Rate for Payer: UHC Core |
$22,556.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,753.57
|
| Rate for Payer: UHC Exchange |
$6,753.57
|
| Rate for Payer: UHC Medicare Advantage |
$6,753.57
|
| Rate for Payer: UHCCP Medicaid |
$5,486.20
|
| Rate for Payer: VA VA |
$6,753.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,260.71
|
|
|
HC ELM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ELM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
