|
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 |
$585.22
|
| 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 |
$585.22
|
| 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 |
$585.22
|
| 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 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
|
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 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 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 |
$5,375.27 |
| 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 |
$5,644.40
|
| 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 |
$5,375.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,091.25
|
| Rate for Payer: Meridian Medicaid |
$5,644.40
|
| 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 |
$5,375.27
|
| 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 |
$5,375.27
|
| 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
|
|
|
HC ELVAREX CHAP STYLE ONE LEG
|
Facility
|
IP
|
$584.55
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000368
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$379.96 |
| Max. Negotiated Rate |
$526.10 |
| Rate for Payer: Aetna Commercial |
$496.87
|
| Rate for Payer: BCBS Trust/PPO |
$477.17
|
| Rate for Payer: BCN Commercial |
$451.74
|
| Rate for Payer: Cash Price |
$467.64
|
| Rate for Payer: Cofinity Commercial |
$502.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.64
|
| Rate for Payer: Healthscope Commercial |
$526.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.87
|
| Rate for Payer: Nomi Health Commercial |
$479.33
|
| Rate for Payer: PHP Commercial |
$496.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.96
|
| Rate for Payer: Priority Health HMO/PPO |
$508.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.40
|
| Rate for Payer: UHC Core |
$488.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.41
|
|
|
HC ELVAREX CHAP STYLE ONE LEG
|
Facility
|
OP
|
$584.55
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000368
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$138.83 |
| Max. Negotiated Rate |
$526.10 |
| Rate for Payer: Aetna Commercial |
$496.87
|
| Rate for Payer: Aetna Medicare |
$151.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.67
|
| Rate for Payer: BCBS Complete |
$233.82
|
| Rate for Payer: BCBS MAPPO |
$146.14
|
| Rate for Payer: BCBS Trust/PPO |
$480.56
|
| Rate for Payer: BCN Commercial |
$454.49
|
| Rate for Payer: BCN Medicare Advantage |
$146.14
|
| Rate for Payer: Cash Price |
$467.64
|
| Rate for Payer: Cofinity Commercial |
$502.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.14
|
| Rate for Payer: Healthscope Commercial |
$526.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.87
|
| Rate for Payer: Nomi Health Commercial |
$479.33
|
| Rate for Payer: PACE Senior Care Partners |
$138.83
|
| Rate for Payer: PACE SWMI |
$146.14
|
| Rate for Payer: PHP Commercial |
$496.87
|
| Rate for Payer: PHP Medicare Advantage |
$146.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.96
|
| Rate for Payer: Priority Health HMO/PPO |
$508.56
|
| Rate for Payer: Priority Health Medicare |
$147.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.65
|
| Rate for Payer: Railroad Medicare Medicare |
$146.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.40
|
| Rate for Payer: UHC Core |
$488.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.14
|
| Rate for Payer: UHC Exchange |
$146.14
|
| Rate for Payer: UHC Medicare Advantage |
$146.14
|
| Rate for Payer: VA VA |
$146.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.41
|
|
|
HC ELVAREX CHAP STYLE TWO LEG
|
Facility
|
IP
|
$1,169.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000369
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$759.90 |
| Max. Negotiated Rate |
$1,052.16 |
| Rate for Payer: Aetna Commercial |
$993.71
|
| Rate for Payer: BCBS Trust/PPO |
$954.31
|
| Rate for Payer: BCN Commercial |
$903.46
|
| Rate for Payer: Cash Price |
$935.26
|
| Rate for Payer: Cofinity Commercial |
$1,005.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.26
|
| Rate for Payer: Healthscope Commercial |
$1,052.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$876.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.71
|
| Rate for Payer: Nomi Health Commercial |
$958.64
|
| Rate for Payer: PHP Commercial |
$993.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,017.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.78
|
| Rate for Payer: UHC Core |
$976.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$876.80
|
|
|
HC ELVAREX CHAP STYLE TWO LEG
|
Facility
|
OP
|
$1,169.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000369
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$277.65 |
| Max. Negotiated Rate |
$1,052.16 |
| Rate for Payer: Aetna Commercial |
$993.71
|
| Rate for Payer: Aetna Medicare |
$303.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$365.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$365.33
|
| Rate for Payer: BCBS Complete |
$467.63
|
| Rate for Payer: BCBS MAPPO |
$292.27
|
| Rate for Payer: BCBS Trust/PPO |
$961.09
|
| Rate for Payer: BCN Commercial |
$908.95
|
| Rate for Payer: BCN Medicare Advantage |
$292.27
|
| Rate for Payer: Cash Price |
$935.26
|
| Rate for Payer: Cofinity Commercial |
$1,005.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.27
|
| Rate for Payer: Healthscope Commercial |
$1,052.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$876.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$336.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.71
|
| Rate for Payer: Nomi Health Commercial |
$958.64
|
| Rate for Payer: PACE Senior Care Partners |
$277.65
|
| Rate for Payer: PACE SWMI |
$292.27
|
| Rate for Payer: PHP Commercial |
$993.71
|
| Rate for Payer: PHP Medicare Advantage |
$292.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,017.09
|
| Rate for Payer: Priority Health Medicare |
$295.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.28
|
| Rate for Payer: Railroad Medicare Medicare |
$292.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.78
|
| Rate for Payer: UHC Core |
$976.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.27
|
| Rate for Payer: UHC Exchange |
$292.27
|
| Rate for Payer: UHC Medicare Advantage |
$292.27
|
| Rate for Payer: VA VA |
$292.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$876.80
|
|
|
HC ELVAREX KNEE SLANT OPEN TOE
|
Facility
|
IP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$186.47 |
| Max. Negotiated Rate |
$258.19 |
| Rate for Payer: Aetna Commercial |
$243.85
|
| Rate for Payer: BCBS Trust/PPO |
$234.18
|
| Rate for Payer: BCN Commercial |
$221.70
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Healthscope Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: PHP Commercial |
$243.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: Priority Health HMO/PPO |
$249.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.45
|
| Rate for Payer: UHC Core |
$239.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.16
|
|
|
HC ELVAREX KNEE SLANT OPEN TOE
|
Facility
|
OP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000366
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$68.13 |
| Max. Negotiated Rate |
$258.19 |
| Rate for Payer: Aetna Commercial |
$243.85
|
| Rate for Payer: Aetna Medicare |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.65
|
| Rate for Payer: BCBS Complete |
$114.75
|
| Rate for Payer: BCBS MAPPO |
$71.72
|
| Rate for Payer: BCBS Trust/PPO |
$235.84
|
| Rate for Payer: BCN Commercial |
$223.05
|
| Rate for Payer: BCN Medicare Advantage |
$71.72
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.72
|
| Rate for Payer: Healthscope Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: PACE Senior Care Partners |
$68.13
|
| Rate for Payer: PACE SWMI |
$71.72
|
| Rate for Payer: PHP Commercial |
$243.85
|
| Rate for Payer: PHP Medicare Advantage |
$71.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: Priority Health HMO/PPO |
$249.59
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.21
|
| Rate for Payer: Railroad Medicare Medicare |
$71.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.45
|
| Rate for Payer: UHC Core |
$239.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.72
|
| Rate for Payer: UHC Exchange |
$71.72
|
| Rate for Payer: UHC Medicare Advantage |
$71.72
|
| Rate for Payer: VA VA |
$71.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.16
|
|
|
HC ELVAREX SLEEVE
|
Facility
|
IP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000365
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$165.48 |
| Max. Negotiated Rate |
$229.13 |
| Rate for Payer: Aetna Commercial |
$216.40
|
| Rate for Payer: BCBS Trust/PPO |
$207.82
|
| Rate for Payer: BCN Commercial |
$196.75
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$218.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$229.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: PHP Commercial |
$216.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO |
$221.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.04
|
| Rate for Payer: UHC Core |
$212.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.94
|
|
|
HC ELVAREX SLEEVE
|
Facility
|
OP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000365
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$229.13 |
| Rate for Payer: Aetna Commercial |
$216.40
|
| Rate for Payer: Aetna Medicare |
$66.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.56
|
| Rate for Payer: BCBS Complete |
$101.84
|
| Rate for Payer: BCBS MAPPO |
$63.65
|
| Rate for Payer: BCBS Trust/PPO |
$209.30
|
| Rate for Payer: BCN Commercial |
$197.94
|
| Rate for Payer: BCN Medicare Advantage |
$63.65
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$218.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$229.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: PACE Senior Care Partners |
$60.47
|
| Rate for Payer: PACE SWMI |
$63.65
|
| Rate for Payer: PHP Commercial |
$216.40
|
| Rate for Payer: PHP Medicare Advantage |
$63.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO |
$221.49
|
| Rate for Payer: Priority Health Medicare |
$64.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.58
|
| Rate for Payer: Railroad Medicare Medicare |
$63.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.04
|
| Rate for Payer: UHC Core |
$212.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.65
|
| Rate for Payer: UHC Exchange |
$63.65
|
| Rate for Payer: UHC Medicare Advantage |
$63.65
|
| Rate for Payer: VA VA |
$63.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.94
|
|
|
HC ELVAREX SOFT ARMSLEEVE
|
Facility
|
OP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$229.13 |
| Rate for Payer: Aetna Commercial |
$216.40
|
| Rate for Payer: Aetna Medicare |
$66.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.56
|
| Rate for Payer: BCBS Complete |
$101.84
|
| Rate for Payer: BCBS MAPPO |
$63.65
|
| Rate for Payer: BCBS Trust/PPO |
$209.30
|
| Rate for Payer: BCN Commercial |
$197.94
|
| Rate for Payer: BCN Medicare Advantage |
$63.65
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$218.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$229.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: PACE Senior Care Partners |
$60.47
|
| Rate for Payer: PACE SWMI |
$63.65
|
| Rate for Payer: PHP Commercial |
$216.40
|
| Rate for Payer: PHP Medicare Advantage |
$63.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO |
$221.49
|
| Rate for Payer: Priority Health Medicare |
$64.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.58
|
| Rate for Payer: Railroad Medicare Medicare |
$63.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.04
|
| Rate for Payer: UHC Core |
$212.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.65
|
| Rate for Payer: UHC Exchange |
$63.65
|
| Rate for Payer: UHC Medicare Advantage |
$63.65
|
| Rate for Payer: VA VA |
$63.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.94
|
|
|
HC ELVAREX SOFT ARMSLEEVE
|
Facility
|
IP
|
$254.59
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000372
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$165.48 |
| Max. Negotiated Rate |
$229.13 |
| Rate for Payer: Aetna Commercial |
$216.40
|
| Rate for Payer: BCBS Trust/PPO |
$207.82
|
| Rate for Payer: BCN Commercial |
$196.75
|
| Rate for Payer: Cash Price |
$203.67
|
| Rate for Payer: Cofinity Commercial |
$218.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.67
|
| Rate for Payer: Healthscope Commercial |
$229.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.40
|
| Rate for Payer: Nomi Health Commercial |
$208.76
|
| Rate for Payer: PHP Commercial |
$216.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.48
|
| Rate for Payer: Priority Health HMO/PPO |
$221.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.04
|
| Rate for Payer: UHC Core |
$212.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.94
|
|
|
HC ELVAREX SOFT KNEE CLOSED T
|
Facility
|
OP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000373
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$68.13 |
| Max. Negotiated Rate |
$258.19 |
| Rate for Payer: Aetna Commercial |
$243.85
|
| Rate for Payer: Aetna Medicare |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.65
|
| Rate for Payer: BCBS Complete |
$114.75
|
| Rate for Payer: BCBS MAPPO |
$71.72
|
| Rate for Payer: BCBS Trust/PPO |
$235.84
|
| Rate for Payer: BCN Commercial |
$223.05
|
| Rate for Payer: BCN Medicare Advantage |
$71.72
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.72
|
| Rate for Payer: Healthscope Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: PACE Senior Care Partners |
$68.13
|
| Rate for Payer: PACE SWMI |
$71.72
|
| Rate for Payer: PHP Commercial |
$243.85
|
| Rate for Payer: PHP Medicare Advantage |
$71.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: Priority Health HMO/PPO |
$249.59
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.21
|
| Rate for Payer: Railroad Medicare Medicare |
$71.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.45
|
| Rate for Payer: UHC Core |
$239.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.72
|
| Rate for Payer: UHC Exchange |
$71.72
|
| Rate for Payer: UHC Medicare Advantage |
$71.72
|
| Rate for Payer: VA VA |
$71.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.16
|
|
|
HC ELVAREX SOFT KNEE CLOSED T
|
Facility
|
IP
|
$286.88
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000373
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$186.47 |
| Max. Negotiated Rate |
$258.19 |
| Rate for Payer: Aetna Commercial |
$243.85
|
| Rate for Payer: BCBS Trust/PPO |
$234.18
|
| Rate for Payer: BCN Commercial |
$221.70
|
| Rate for Payer: Cash Price |
$229.50
|
| Rate for Payer: Cofinity Commercial |
$246.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.50
|
| Rate for Payer: Healthscope Commercial |
$258.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.85
|
| Rate for Payer: Nomi Health Commercial |
$235.24
|
| Rate for Payer: PHP Commercial |
$243.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.47
|
| Rate for Payer: Priority Health HMO/PPO |
$249.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.45
|
| Rate for Payer: UHC Core |
$239.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.16
|
|
|
HC ELVAREX THIGH SLANT OPEN TOE
|
Facility
|
IP
|
$419.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000367
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$272.75 |
| Max. Negotiated Rate |
$377.66 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: BCBS Trust/PPO |
$342.54
|
| Rate for Payer: BCN Commercial |
$324.28
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cofinity Commercial |
$360.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.70
|
| Rate for Payer: Healthscope Commercial |
$377.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.68
|
| Rate for Payer: Nomi Health Commercial |
$344.09
|
| Rate for Payer: PHP Commercial |
$356.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.75
|
| Rate for Payer: Priority Health HMO/PPO |
$365.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.27
|
| Rate for Payer: UHC Core |
$350.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.72
|
|
|
HC ELVAREX THIGH SLANT OPEN TOE
|
Facility
|
OP
|
$419.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000367
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.66 |
| Max. Negotiated Rate |
$377.66 |
| Rate for Payer: Aetna Commercial |
$356.68
|
| Rate for Payer: Aetna Medicare |
$109.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.13
|
| Rate for Payer: BCBS Complete |
$167.85
|
| Rate for Payer: BCBS MAPPO |
$104.90
|
| Rate for Payer: BCBS Trust/PPO |
$344.97
|
| Rate for Payer: BCN Commercial |
$326.25
|
| Rate for Payer: BCN Medicare Advantage |
$104.90
|
| Rate for Payer: Cash Price |
$335.70
|
| Rate for Payer: Cofinity Commercial |
$360.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.90
|
| Rate for Payer: Healthscope Commercial |
$377.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$356.68
|
| Rate for Payer: Nomi Health Commercial |
$344.09
|
| Rate for Payer: PACE Senior Care Partners |
$99.66
|
| Rate for Payer: PACE SWMI |
$104.90
|
| Rate for Payer: PHP Commercial |
$356.68
|
| Rate for Payer: PHP Medicare Advantage |
$104.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.75
|
| Rate for Payer: Priority Health HMO/PPO |
$365.07
|
| Rate for Payer: Priority Health Medicare |
$105.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.15
|
| Rate for Payer: Railroad Medicare Medicare |
$104.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.27
|
| Rate for Payer: UHC Core |
$350.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.90
|
| Rate for Payer: UHC Exchange |
$104.90
|
| Rate for Payer: UHC Medicare Advantage |
$104.90
|
| Rate for Payer: VA VA |
$104.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.72
|
|
|
HC ELVAREX WAIST HIGH PRESSURE
|
Facility
|
OP
|
$538.93
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000370
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$128.00 |
| Max. Negotiated Rate |
$485.04 |
| Rate for Payer: Aetna Commercial |
$458.09
|
| Rate for Payer: Aetna Medicare |
$140.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.42
|
| Rate for Payer: BCBS Complete |
$215.57
|
| Rate for Payer: BCBS MAPPO |
$134.73
|
| Rate for Payer: BCBS Trust/PPO |
$443.05
|
| Rate for Payer: BCN Commercial |
$419.02
|
| Rate for Payer: BCN Medicare Advantage |
$134.73
|
| Rate for Payer: Cash Price |
$431.14
|
| Rate for Payer: Cofinity Commercial |
$463.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.73
|
| Rate for Payer: Healthscope Commercial |
$485.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$458.09
|
| Rate for Payer: Nomi Health Commercial |
$441.92
|
| Rate for Payer: PACE Senior Care Partners |
$128.00
|
| Rate for Payer: PACE SWMI |
$134.73
|
| Rate for Payer: PHP Commercial |
$458.09
|
| Rate for Payer: PHP Medicare Advantage |
$134.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.30
|
| Rate for Payer: Priority Health HMO/PPO |
$468.87
|
| Rate for Payer: Priority Health Medicare |
$136.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$361.08
|
| Rate for Payer: Railroad Medicare Medicare |
$134.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.26
|
| Rate for Payer: UHC Core |
$450.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.73
|
| Rate for Payer: UHC Exchange |
$134.73
|
| Rate for Payer: UHC Medicare Advantage |
$134.73
|
| Rate for Payer: VA VA |
$134.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.20
|
|
|
HC ELVAREX WAIST HIGH PRESSURE
|
Facility
|
IP
|
$538.93
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
27000370
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$350.30 |
| Max. Negotiated Rate |
$485.04 |
| Rate for Payer: Aetna Commercial |
$458.09
|
| Rate for Payer: BCBS Trust/PPO |
$439.93
|
| Rate for Payer: BCN Commercial |
$416.49
|
| Rate for Payer: Cash Price |
$431.14
|
| Rate for Payer: Cofinity Commercial |
$463.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.14
|
| Rate for Payer: Healthscope Commercial |
$485.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$458.09
|
| Rate for Payer: Nomi Health Commercial |
$441.92
|
| Rate for Payer: PHP Commercial |
$458.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.30
|
| Rate for Payer: Priority Health HMO/PPO |
$468.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$361.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.26
|
| Rate for Payer: UHC Core |
$450.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.20
|
|
