|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
IP
|
$1,154.20
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$703.95 |
| Max. Negotiated Rate |
$1,038.78 |
| Rate for Payer: Aetna Commercial |
$981.07
|
| Rate for Payer: BCBS Trust/PPO |
$891.97
|
| Rate for Payer: BCN Commercial |
$891.97
|
| Rate for Payer: Cash Price |
$923.36
|
| Rate for Payer: Cofinity Commercial |
$992.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.36
|
| Rate for Payer: Healthscope Commercial |
$1,038.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$865.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$981.07
|
| Rate for Payer: PHP Commercial |
$981.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,004.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.70
|
| Rate for Payer: UHC Core |
$963.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$865.65
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
OP
|
$365.48
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$86.80 |
| Max. Negotiated Rate |
$328.93 |
| Rate for Payer: Aetna Commercial |
$310.66
|
| Rate for Payer: Aetna Medicare |
$95.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.21
|
| Rate for Payer: BCBS Complete |
$146.19
|
| Rate for Payer: BCBS MAPPO |
$91.37
|
| Rate for Payer: BCBS Trust/PPO |
$284.16
|
| Rate for Payer: BCCCP Commercial |
$127.76
|
| Rate for Payer: BCN Commercial |
$284.16
|
| Rate for Payer: BCN Medicare Advantage |
$91.37
|
| Rate for Payer: Cash Price |
$292.38
|
| Rate for Payer: Cash Price |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$314.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.37
|
| Rate for Payer: Healthscope Commercial |
$328.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$310.66
|
| Rate for Payer: PACE Senior Care Partners |
$86.80
|
| Rate for Payer: PACE SWMI |
$91.37
|
| Rate for Payer: PHP Commercial |
$310.66
|
| Rate for Payer: PHP Medicare Advantage |
$91.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.97
|
| Rate for Payer: Priority Health Medicare |
$91.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.91
|
| Rate for Payer: Railroad Medicare Medicare |
$91.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.62
|
| Rate for Payer: UHC Core |
$305.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.37
|
| Rate for Payer: UHC Medicare Advantage |
$94.11
|
| Rate for Payer: VA VA |
$91.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.11
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
IP
|
$365.48
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$222.91 |
| Max. Negotiated Rate |
$328.93 |
| Rate for Payer: Aetna Commercial |
$310.66
|
| Rate for Payer: BCBS Trust/PPO |
$282.44
|
| Rate for Payer: BCN Commercial |
$282.44
|
| Rate for Payer: Cash Price |
$292.38
|
| Rate for Payer: Cofinity Commercial |
$314.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.38
|
| Rate for Payer: Healthscope Commercial |
$328.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$310.66
|
| Rate for Payer: PHP Commercial |
$310.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.62
|
| Rate for Payer: UHC Core |
$305.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.11
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
OP
|
$580.45
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$522.40 |
| Rate for Payer: Aetna Commercial |
$493.38
|
| Rate for Payer: Aetna Medicare |
$150.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.39
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$145.11
|
| Rate for Payer: BCBS Trust/PPO |
$451.30
|
| Rate for Payer: BCCCP Commercial |
$70.40
|
| Rate for Payer: BCN Commercial |
$451.30
|
| Rate for Payer: BCN Medicare Advantage |
$145.11
|
| Rate for Payer: Cash Price |
$464.36
|
| Rate for Payer: Cash Price |
$464.36
|
| Rate for Payer: Cofinity Commercial |
$499.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.11
|
| Rate for Payer: Healthscope Commercial |
$522.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.34
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.38
|
| Rate for Payer: PACE Senior Care Partners |
$137.86
|
| Rate for Payer: PACE SWMI |
$145.11
|
| Rate for Payer: PHP Commercial |
$493.38
|
| Rate for Payer: PHP Medicare Advantage |
$145.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.99
|
| Rate for Payer: Priority Health Medicare |
$145.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.02
|
| Rate for Payer: Railroad Medicare Medicare |
$145.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.80
|
| Rate for Payer: UHC Core |
$484.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.11
|
| Rate for Payer: UHC Medicare Advantage |
$149.47
|
| Rate for Payer: VA VA |
$145.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.34
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
IP
|
$580.45
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$354.02 |
| Max. Negotiated Rate |
$522.40 |
| Rate for Payer: Aetna Commercial |
$493.38
|
| Rate for Payer: BCBS Trust/PPO |
$448.57
|
| Rate for Payer: BCN Commercial |
$448.57
|
| Rate for Payer: Cash Price |
$464.36
|
| Rate for Payer: Cofinity Commercial |
$499.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.36
|
| Rate for Payer: Healthscope Commercial |
$522.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.38
|
| Rate for Payer: PHP Commercial |
$493.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.80
|
| Rate for Payer: UHC Core |
$484.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.34
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
IP
|
$700.46
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$427.21 |
| Max. Negotiated Rate |
$630.41 |
| Rate for Payer: Aetna Commercial |
$595.39
|
| Rate for Payer: BCBS Trust/PPO |
$541.32
|
| Rate for Payer: BCN Commercial |
$541.32
|
| Rate for Payer: Cash Price |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$602.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.37
|
| Rate for Payer: Healthscope Commercial |
$630.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.39
|
| Rate for Payer: PHP Commercial |
$595.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.40
|
| Rate for Payer: UHC Core |
$584.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.34
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
OP
|
$700.46
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.57 |
| Max. Negotiated Rate |
$630.41 |
| Rate for Payer: Aetna Commercial |
$595.39
|
| Rate for Payer: Aetna Medicare |
$182.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.89
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$175.12
|
| Rate for Payer: BCBS Trust/PPO |
$544.61
|
| Rate for Payer: BCCCP Commercial |
$54.57
|
| Rate for Payer: BCN Commercial |
$544.61
|
| Rate for Payer: BCN Medicare Advantage |
$175.12
|
| Rate for Payer: Cash Price |
$560.37
|
| Rate for Payer: Cash Price |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$602.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.12
|
| Rate for Payer: Healthscope Commercial |
$630.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.34
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.39
|
| Rate for Payer: PACE Senior Care Partners |
$166.36
|
| Rate for Payer: PACE SWMI |
$175.12
|
| Rate for Payer: PHP Commercial |
$595.39
|
| Rate for Payer: PHP Medicare Advantage |
$175.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.40
|
| Rate for Payer: Priority Health Medicare |
$175.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.21
|
| Rate for Payer: Railroad Medicare Medicare |
$175.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.40
|
| Rate for Payer: UHC Core |
$584.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.12
|
| Rate for Payer: UHC Medicare Advantage |
$180.37
|
| Rate for Payer: VA VA |
$175.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.34
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$82.50
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$74.25 |
| Rate for Payer: Aetna Commercial |
$70.12
|
| Rate for Payer: Aetna Medicare |
$21.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.78
|
| Rate for Payer: BCBS Complete |
$33.00
|
| Rate for Payer: BCBS MAPPO |
$20.62
|
| Rate for Payer: BCBS Trust/PPO |
$64.14
|
| Rate for Payer: BCN Commercial |
$64.14
|
| Rate for Payer: BCN Medicare Advantage |
$20.62
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cofinity Commercial |
$70.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.62
|
| Rate for Payer: Healthscope Commercial |
$74.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.12
|
| Rate for Payer: PACE Senior Care Partners |
$19.59
|
| Rate for Payer: PACE SWMI |
$20.62
|
| Rate for Payer: PHP Commercial |
$70.12
|
| Rate for Payer: PHP Medicare Advantage |
$20.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.78
|
| Rate for Payer: Priority Health Medicare |
$20.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.32
|
| Rate for Payer: Railroad Medicare Medicare |
$20.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.60
|
| Rate for Payer: UHC Core |
$68.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.62
|
| Rate for Payer: UHC Medicare Advantage |
$21.24
|
| Rate for Payer: VA VA |
$20.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.88
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$82.50
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$74.25 |
| Rate for Payer: Aetna Commercial |
$70.12
|
| Rate for Payer: BCBS Trust/PPO |
$63.76
|
| Rate for Payer: BCN Commercial |
$63.76
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cofinity Commercial |
$70.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.00
|
| Rate for Payer: Healthscope Commercial |
$74.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.12
|
| Rate for Payer: PHP Commercial |
$70.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.60
|
| Rate for Payer: UHC Core |
$68.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.88
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,000.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$3,400.00
|
| Rate for Payer: Aetna Medicare |
$1,040.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,250.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,250.00
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$1,000.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,110.00
|
| Rate for Payer: BCN Commercial |
$3,110.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,000.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$3,440.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,000.00
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,050.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,400.00
|
| Rate for Payer: PACE Senior Care Partners |
$950.00
|
| Rate for Payer: PACE SWMI |
$1,000.00
|
| Rate for Payer: PHP Commercial |
$3,400.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,000.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,480.00
|
| Rate for Payer: Priority Health Medicare |
$1,000.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,000.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,520.00
|
| Rate for Payer: UHC Core |
$3,340.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,000.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,030.00
|
| Rate for Payer: VA VA |
$1,000.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,000.00
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,000.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,439.60 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna Commercial |
$3,400.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,091.20
|
| Rate for Payer: BCN Commercial |
$3,091.20
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$3,440.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,200.00
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,400.00
|
| Rate for Payer: PHP Commercial |
$3,400.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,480.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,520.00
|
| Rate for Payer: UHC Core |
$3,340.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,000.00
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$484.50
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.50 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: BCBS Trust/PPO |
$374.42
|
| Rate for Payer: BCN Commercial |
$374.42
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cofinity Commercial |
$416.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.60
|
| Rate for Payer: Healthscope Commercial |
$436.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.82
|
| Rate for Payer: PHP Commercial |
$411.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.36
|
| Rate for Payer: UHC Core |
$404.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.38
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$484.50
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.07 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: Aetna Medicare |
$125.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.41
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$121.12
|
| Rate for Payer: BCBS Trust/PPO |
$376.70
|
| Rate for Payer: BCN Commercial |
$376.70
|
| Rate for Payer: BCN Medicare Advantage |
$121.12
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cofinity Commercial |
$416.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.12
|
| Rate for Payer: Healthscope Commercial |
$436.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.38
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.82
|
| Rate for Payer: PACE Senior Care Partners |
$115.07
|
| Rate for Payer: PACE SWMI |
$121.12
|
| Rate for Payer: PHP Commercial |
$411.82
|
| Rate for Payer: PHP Medicare Advantage |
$121.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.52
|
| Rate for Payer: Priority Health Medicare |
$121.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.50
|
| Rate for Payer: Railroad Medicare Medicare |
$121.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.36
|
| Rate for Payer: UHC Core |
$404.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.12
|
| Rate for Payer: UHC Medicare Advantage |
$124.76
|
| Rate for Payer: VA VA |
$121.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.38
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,463.70
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$347.63 |
| Max. Negotiated Rate |
$1,317.33 |
| Rate for Payer: Aetna Commercial |
$1,244.14
|
| Rate for Payer: Aetna Medicare |
$380.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$457.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$457.41
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$365.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,138.03
|
| Rate for Payer: BCN Commercial |
$1,138.03
|
| Rate for Payer: BCN Medicare Advantage |
$365.92
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cofinity Commercial |
$1,258.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.92
|
| Rate for Payer: Healthscope Commercial |
$1,317.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.78
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,244.14
|
| Rate for Payer: PACE Senior Care Partners |
$347.63
|
| Rate for Payer: PACE SWMI |
$365.92
|
| Rate for Payer: PHP Commercial |
$1,244.14
|
| Rate for Payer: PHP Medicare Advantage |
$365.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,024.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.42
|
| Rate for Payer: Priority Health Medicare |
$365.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$892.71
|
| Rate for Payer: Railroad Medicare Medicare |
$365.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.06
|
| Rate for Payer: UHC Core |
$1,222.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$365.92
|
| Rate for Payer: UHC Medicare Advantage |
$376.90
|
| Rate for Payer: VA VA |
$365.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.78
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,463.70
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$892.71 |
| Max. Negotiated Rate |
$1,317.33 |
| Rate for Payer: Aetna Commercial |
$1,244.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,131.15
|
| Rate for Payer: BCN Commercial |
$1,131.15
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cofinity Commercial |
$1,258.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.96
|
| Rate for Payer: Healthscope Commercial |
$1,317.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,244.14
|
| Rate for Payer: PHP Commercial |
$1,244.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,024.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,273.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$892.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.06
|
| Rate for Payer: UHC Core |
$1,222.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.78
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$691.63 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: BCBS Trust/PPO |
$876.36
|
| Rate for Payer: BCN Commercial |
$876.36
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$975.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$907.20
|
| Rate for Payer: Healthscope Commercial |
$1,020.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$850.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$963.90
|
| Rate for Payer: PHP Commercial |
$963.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$691.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.92
|
| Rate for Payer: UHC Core |
$946.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$850.50
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$269.32 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: Aetna Medicare |
$294.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$354.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$354.38
|
| Rate for Payer: BCBS Complete |
$453.60
|
| Rate for Payer: BCBS MAPPO |
$283.50
|
| Rate for Payer: BCBS Trust/PPO |
$881.68
|
| Rate for Payer: BCN Commercial |
$881.68
|
| Rate for Payer: BCN Medicare Advantage |
$283.50
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$975.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$907.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.50
|
| Rate for Payer: Healthscope Commercial |
$1,020.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$850.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$297.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$326.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$963.90
|
| Rate for Payer: PACE Senior Care Partners |
$269.32
|
| Rate for Payer: PACE SWMI |
$283.50
|
| Rate for Payer: PHP Commercial |
$963.90
|
| Rate for Payer: PHP Medicare Advantage |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$986.58
|
| Rate for Payer: Priority Health Medicare |
$283.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$691.63
|
| Rate for Payer: Railroad Medicare Medicare |
$283.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.92
|
| Rate for Payer: UHC Core |
$946.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.50
|
| Rate for Payer: UHC Medicare Advantage |
$292.00
|
| Rate for Payer: VA VA |
$283.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$850.50
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.19
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$11.35
|
| Rate for Payer: BCBS Trust/PPO |
$35.30
|
| Rate for Payer: BCN Commercial |
$35.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.35
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.35
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Senior Care Partners |
$10.78
|
| Rate for Payer: PACE SWMI |
$11.35
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$11.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Medicare |
$11.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.35
|
| Rate for Payer: UHC Medicare Advantage |
$11.69
|
| Rate for Payer: VA VA |
$11.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: BCBS Trust/PPO |
$35.09
|
| Rate for Payer: BCN Commercial |
$35.09
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,048.60
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,689.04 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,674.36
|
| Rate for Payer: BCN Commercial |
$4,674.36
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,234.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,262.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,689.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,322.77
|
| Rate for Payer: UHC Core |
$5,050.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,048.60
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,436.54 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna Medicare |
$1,572.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,890.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,890.19
|
| Rate for Payer: BCBS Complete |
$2,419.44
|
| Rate for Payer: BCBS MAPPO |
$1,512.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,702.79
|
| Rate for Payer: BCN Commercial |
$4,702.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,512.15
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,512.15
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,587.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,738.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,141.31
|
| Rate for Payer: PACE Senior Care Partners |
$1,436.54
|
| Rate for Payer: PACE SWMI |
$1,512.15
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,512.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,234.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,262.28
|
| Rate for Payer: Priority Health Medicare |
$1,512.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,689.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,512.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,322.77
|
| Rate for Payer: UHC Core |
$5,050.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,512.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,557.51
|
| Rate for Payer: VA VA |
$1,512.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,311.84
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,629.79 |
| Max. Negotiated Rate |
$3,880.66 |
| Rate for Payer: Aetna Commercial |
$3,665.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,332.19
|
| Rate for Payer: BCN Commercial |
$3,332.19
|
| Rate for Payer: Cash Price |
$3,449.47
|
| Rate for Payer: Cofinity Commercial |
$3,708.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,449.47
|
| Rate for Payer: Healthscope Commercial |
$3,880.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,233.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,665.06
|
| Rate for Payer: PHP Commercial |
$3,665.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,751.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,629.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,794.42
|
| Rate for Payer: UHC Core |
$3,600.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,233.88
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,311.84
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,024.06 |
| Max. Negotiated Rate |
$3,880.66 |
| Rate for Payer: Aetna Commercial |
$3,665.06
|
| Rate for Payer: Aetna Medicare |
$1,121.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,347.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,347.45
|
| Rate for Payer: BCBS Complete |
$1,724.74
|
| Rate for Payer: BCBS MAPPO |
$1,077.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,352.46
|
| Rate for Payer: BCN Commercial |
$3,352.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,077.96
|
| Rate for Payer: Cash Price |
$3,449.47
|
| Rate for Payer: Cofinity Commercial |
$3,708.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,449.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,077.96
|
| Rate for Payer: Healthscope Commercial |
$3,880.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,233.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,131.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,239.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,665.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,024.06
|
| Rate for Payer: PACE SWMI |
$1,077.96
|
| Rate for Payer: PHP Commercial |
$3,665.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,077.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,751.30
|
| Rate for Payer: Priority Health Medicare |
$1,077.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,629.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,077.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,794.42
|
| Rate for Payer: UHC Core |
$3,600.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,077.96
|
| Rate for Payer: UHC Medicare Advantage |
$1,110.30
|
| Rate for Payer: VA VA |
$1,077.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,233.88
|
|
