|
HC ELVAREX ZIPPER
|
Facility
|
OP
|
$69.28
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000371
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$62.35 |
| Rate for Payer: Aetna Commercial |
$58.89
|
| Rate for Payer: Aetna Medicare |
$18.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.65
|
| Rate for Payer: BCBS Complete |
$27.71
|
| Rate for Payer: BCBS MAPPO |
$17.32
|
| Rate for Payer: BCBS Trust/PPO |
$56.96
|
| Rate for Payer: BCN Commercial |
$53.87
|
| Rate for Payer: BCN Medicare Advantage |
$17.32
|
| Rate for Payer: Cash Price |
$55.42
|
| Rate for Payer: Cofinity Commercial |
$59.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.32
|
| Rate for Payer: Healthscope Commercial |
$62.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.89
|
| Rate for Payer: Nomi Health Commercial |
$56.81
|
| Rate for Payer: PACE Senior Care Partners |
$16.45
|
| Rate for Payer: PACE SWMI |
$17.32
|
| Rate for Payer: PHP Commercial |
$58.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.03
|
| Rate for Payer: Priority Health HMO/PPO |
$60.27
|
| Rate for Payer: Priority Health Medicare |
$17.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.42
|
| Rate for Payer: Railroad Medicare Medicare |
$17.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.97
|
| Rate for Payer: UHC Core |
$57.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.32
|
| Rate for Payer: UHC Exchange |
$17.32
|
| Rate for Payer: UHC Medicare Advantage |
$17.32
|
| Rate for Payer: VA VA |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.96
|
|
|
HC ELVAREX ZIPPER
|
Facility
|
IP
|
$69.28
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000371
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.03 |
| Max. Negotiated Rate |
$62.35 |
| Rate for Payer: Aetna Commercial |
$58.89
|
| Rate for Payer: BCBS Trust/PPO |
$56.55
|
| Rate for Payer: BCN Commercial |
$53.54
|
| Rate for Payer: Cash Price |
$55.42
|
| Rate for Payer: Cofinity Commercial |
$59.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.42
|
| Rate for Payer: Healthscope Commercial |
$62.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.89
|
| Rate for Payer: Nomi Health Commercial |
$56.81
|
| Rate for Payer: PHP Commercial |
$58.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.03
|
| Rate for Payer: Priority Health HMO/PPO |
$60.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.97
|
| Rate for Payer: UHC Core |
$57.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.96
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
OP
|
$11,857.50
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,816.16 |
| Max. Negotiated Rate |
$10,671.75 |
| Rate for Payer: Aetna Commercial |
$10,078.88
|
| Rate for Payer: Aetna Medicare |
$3,082.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,705.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,705.47
|
| Rate for Payer: BCBS Complete |
$4,743.00
|
| Rate for Payer: BCBS MAPPO |
$2,964.38
|
| Rate for Payer: BCBS Trust/PPO |
$9,748.05
|
| Rate for Payer: BCN Commercial |
$9,219.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,964.38
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$10,197.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,964.38
|
| Rate for Payer: Healthscope Commercial |
$10,671.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,893.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,112.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,409.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: PACE Senior Care Partners |
$2,816.16
|
| Rate for Payer: PACE SWMI |
$2,964.38
|
| Rate for Payer: PHP Commercial |
$10,078.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,964.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: Priority Health HMO/PPO |
$10,316.02
|
| Rate for Payer: Priority Health Medicare |
$2,994.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,944.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,964.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,434.60
|
| Rate for Payer: UHC Core |
$9,901.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,964.38
|
| Rate for Payer: UHC Exchange |
$2,964.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,964.38
|
| Rate for Payer: VA VA |
$2,964.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,893.12
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
IP
|
$11,857.50
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,707.38 |
| Max. Negotiated Rate |
$10,671.75 |
| Rate for Payer: Aetna Commercial |
$10,078.88
|
| Rate for Payer: BCBS Trust/PPO |
$9,679.28
|
| Rate for Payer: BCN Commercial |
$9,163.48
|
| Rate for Payer: Cash Price |
$9,486.00
|
| Rate for Payer: Cofinity Commercial |
$10,197.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,486.00
|
| Rate for Payer: Healthscope Commercial |
$10,671.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,893.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,078.88
|
| Rate for Payer: Nomi Health Commercial |
$9,723.15
|
| Rate for Payer: PHP Commercial |
$10,078.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,707.38
|
| Rate for Payer: Priority Health HMO/PPO |
$10,316.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,944.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,434.60
|
| Rate for Payer: UHC Core |
$9,901.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,893.12
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,676.41 |
| Max. Negotiated Rate |
$5,090.41 |
| Rate for Payer: Aetna Commercial |
$4,807.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,617.00
|
| Rate for Payer: BCN Commercial |
$4,370.96
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$4,864.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Healthscope Commercial |
$5,090.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,242.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: Nomi Health Commercial |
$4,637.93
|
| Rate for Payer: PHP Commercial |
$4,807.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: Priority Health HMO/PPO |
$4,920.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,789.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,977.29
|
| Rate for Payer: UHC Core |
$4,722.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,242.01
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,343.30 |
| Max. Negotiated Rate |
$5,090.41 |
| Rate for Payer: Aetna Commercial |
$4,807.61
|
| Rate for Payer: Aetna Medicare |
$1,470.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,767.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,767.50
|
| Rate for Payer: BCBS Complete |
$2,262.40
|
| Rate for Payer: BCBS MAPPO |
$1,414.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,649.81
|
| Rate for Payer: BCN Commercial |
$4,397.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,414.00
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$4,864.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,414.00
|
| Rate for Payer: Healthscope Commercial |
$5,090.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,242.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,484.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,626.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: Nomi Health Commercial |
$4,637.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,343.30
|
| Rate for Payer: PACE SWMI |
$1,414.00
|
| Rate for Payer: PHP Commercial |
$4,807.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,414.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: Priority Health HMO/PPO |
$4,920.73
|
| Rate for Payer: Priority Health Medicare |
$1,428.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,789.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,414.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,977.29
|
| Rate for Payer: UHC Core |
$4,722.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,414.00
|
| Rate for Payer: UHC Exchange |
$1,414.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,414.00
|
| Rate for Payer: VA VA |
$1,414.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,242.01
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,841.80 |
| Rate for Payer: Aetna Commercial |
$1,739.48
|
| Rate for Payer: Aetna Medicare |
$532.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$639.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$639.52
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$511.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.39
|
| Rate for Payer: BCN Commercial |
$1,591.11
|
| Rate for Payer: BCN Medicare Advantage |
$511.61
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,759.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.61
|
| Rate for Payer: Healthscope Commercial |
$1,841.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,534.84
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$537.19
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$588.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: Nomi Health Commercial |
$1,678.09
|
| Rate for Payer: PACE Senior Care Partners |
$486.03
|
| Rate for Payer: PACE SWMI |
$511.61
|
| Rate for Payer: PHP Commercial |
$1,739.48
|
| Rate for Payer: PHP Medicare Advantage |
$511.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,780.41
|
| Rate for Payer: Priority Health Medicare |
$516.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,371.12
|
| Rate for Payer: Railroad Medicare Medicare |
$511.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,800.88
|
| Rate for Payer: UHC Core |
$1,708.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.61
|
| Rate for Payer: UHC Exchange |
$511.61
|
| Rate for Payer: UHC Medicare Advantage |
$511.61
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$511.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,534.84
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,330.19 |
| Max. Negotiated Rate |
$1,841.80 |
| Rate for Payer: Aetna Commercial |
$1,739.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.52
|
| Rate for Payer: BCN Commercial |
$1,581.50
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,759.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Healthscope Commercial |
$1,841.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,534.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: Nomi Health Commercial |
$1,678.09
|
| Rate for Payer: PHP Commercial |
$1,739.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,780.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,371.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,800.88
|
| Rate for Payer: UHC Core |
$1,708.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,534.84
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$715.95 |
| Rate for Payer: Aetna Commercial |
$676.18
|
| Rate for Payer: Aetna Medicare |
$206.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.59
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$198.88
|
| Rate for Payer: BCBS Trust/PPO |
$653.98
|
| Rate for Payer: BCN Commercial |
$618.50
|
| Rate for Payer: BCN Medicare Advantage |
$198.88
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.88
|
| Rate for Payer: Healthscope Commercial |
$715.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.62
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.82
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.18
|
| Rate for Payer: Nomi Health Commercial |
$652.31
|
| Rate for Payer: PACE Senior Care Partners |
$188.93
|
| Rate for Payer: PACE SWMI |
$198.88
|
| Rate for Payer: PHP Commercial |
$676.18
|
| Rate for Payer: PHP Medicare Advantage |
$198.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health HMO/PPO |
$692.08
|
| Rate for Payer: Priority Health Medicare |
$200.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.98
|
| Rate for Payer: Railroad Medicare Medicare |
$198.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.04
|
| Rate for Payer: UHC Core |
$664.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.88
|
| Rate for Payer: UHC Exchange |
$198.88
|
| Rate for Payer: UHC Medicare Advantage |
$198.88
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$198.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.62
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$517.08 |
| Max. Negotiated Rate |
$715.95 |
| Rate for Payer: Aetna Commercial |
$676.18
|
| Rate for Payer: BCBS Trust/PPO |
$649.37
|
| Rate for Payer: BCN Commercial |
$614.76
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Healthscope Commercial |
$715.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.18
|
| Rate for Payer: Nomi Health Commercial |
$652.31
|
| Rate for Payer: PHP Commercial |
$676.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health HMO/PPO |
$692.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.04
|
| Rate for Payer: UHC Core |
$664.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.62
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,908.48 |
| Max. Negotiated Rate |
$15,104.04 |
| Rate for Payer: Aetna Commercial |
$14,264.93
|
| Rate for Payer: BCBS Trust/PPO |
$13,699.37
|
| Rate for Payer: BCN Commercial |
$12,969.34
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$14,432.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Healthscope Commercial |
$15,104.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,586.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: Nomi Health Commercial |
$13,761.46
|
| Rate for Payer: PHP Commercial |
$14,264.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14,600.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,244.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,768.40
|
| Rate for Payer: UHC Core |
$14,013.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,586.70
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,985.79 |
| Max. Negotiated Rate |
$15,104.04 |
| Rate for Payer: Aetna Commercial |
$14,264.93
|
| Rate for Payer: Aetna Medicare |
$4,363.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,244.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,244.46
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$4,195.57
|
| Rate for Payer: BCBS Trust/PPO |
$13,796.70
|
| Rate for Payer: BCN Commercial |
$13,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$4,195.57
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$14,432.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,195.57
|
| Rate for Payer: Healthscope Commercial |
$15,104.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,586.70
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,405.35
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,824.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: Nomi Health Commercial |
$13,761.46
|
| Rate for Payer: PACE Senior Care Partners |
$3,985.79
|
| Rate for Payer: PACE SWMI |
$4,195.57
|
| Rate for Payer: PHP Commercial |
$14,264.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,195.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: Priority Health HMO/PPO |
$14,600.57
|
| Rate for Payer: Priority Health Medicare |
$4,237.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,244.12
|
| Rate for Payer: Railroad Medicare Medicare |
$4,195.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,768.40
|
| Rate for Payer: UHC Core |
$14,013.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,195.57
|
| Rate for Payer: UHC Exchange |
$4,195.57
|
| Rate for Payer: UHC Medicare Advantage |
$4,195.57
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$4,195.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,586.70
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,951.13 |
| Max. Negotiated Rate |
$16,547.72 |
| Rate for Payer: Aetna Commercial |
$15,628.40
|
| Rate for Payer: BCBS Trust/PPO |
$15,008.78
|
| Rate for Payer: BCN Commercial |
$14,208.97
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$15,812.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Healthscope Commercial |
$16,547.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,789.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: Nomi Health Commercial |
$15,076.81
|
| Rate for Payer: PHP Commercial |
$15,628.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: Priority Health HMO/PPO |
$15,996.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,318.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,179.99
|
| Rate for Payer: UHC Core |
$15,352.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,789.76
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,366.76 |
| Max. Negotiated Rate |
$16,547.72 |
| Rate for Payer: Aetna Commercial |
$15,628.40
|
| Rate for Payer: Aetna Medicare |
$4,780.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,745.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,745.73
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$4,596.59
|
| Rate for Payer: BCBS Trust/PPO |
$15,115.42
|
| Rate for Payer: BCN Commercial |
$14,295.39
|
| Rate for Payer: BCN Medicare Advantage |
$4,596.59
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$15,812.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,596.59
|
| Rate for Payer: Healthscope Commercial |
$16,547.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,789.76
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,826.42
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,286.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: Nomi Health Commercial |
$15,076.81
|
| Rate for Payer: PACE Senior Care Partners |
$4,366.76
|
| Rate for Payer: PACE SWMI |
$4,596.59
|
| Rate for Payer: PHP Commercial |
$15,628.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,596.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: Priority Health HMO/PPO |
$15,996.12
|
| Rate for Payer: Priority Health Medicare |
$4,642.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,318.85
|
| Rate for Payer: Railroad Medicare Medicare |
$4,596.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,179.99
|
| Rate for Payer: UHC Core |
$15,352.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,596.59
|
| Rate for Payer: UHC Exchange |
$4,596.59
|
| Rate for Payer: UHC Medicare Advantage |
$4,596.59
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$4,596.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,789.76
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
OP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,811.81 |
| Max. Negotiated Rate |
$6,865.82 |
| Rate for Payer: Aetna Commercial |
$6,484.39
|
| Rate for Payer: Aetna Medicare |
$1,983.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,383.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,383.97
|
| Rate for Payer: BCBS Complete |
$3,051.48
|
| Rate for Payer: BCBS MAPPO |
$1,907.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,271.55
|
| Rate for Payer: BCN Commercial |
$5,931.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,907.17
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$6,560.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,907.17
|
| Rate for Payer: Healthscope Commercial |
$6,865.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,721.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,002.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,193.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: Nomi Health Commercial |
$6,255.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,811.81
|
| Rate for Payer: PACE SWMI |
$1,907.17
|
| Rate for Payer: PHP Commercial |
$6,484.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,907.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: Priority Health HMO/PPO |
$6,636.96
|
| Rate for Payer: Priority Health Medicare |
$1,926.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,111.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,907.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,713.25
|
| Rate for Payer: UHC Core |
$6,369.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,907.17
|
| Rate for Payer: UHC Exchange |
$1,907.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,907.17
|
| Rate for Payer: VA VA |
$1,907.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,721.52
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
IP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,958.65 |
| Max. Negotiated Rate |
$6,865.82 |
| Rate for Payer: Aetna Commercial |
$6,484.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,227.30
|
| Rate for Payer: BCN Commercial |
$5,895.45
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$6,560.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Healthscope Commercial |
$6,865.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,721.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: Nomi Health Commercial |
$6,255.53
|
| Rate for Payer: PHP Commercial |
$6,484.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: Priority Health HMO/PPO |
$6,636.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,111.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,713.25
|
| Rate for Payer: UHC Core |
$6,369.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,721.52
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.13 |
| Max. Negotiated Rate |
$1,686.82 |
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: Aetna Medicare |
$487.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$585.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$585.70
|
| Rate for Payer: BCBS Complete |
$749.70
|
| Rate for Payer: BCBS MAPPO |
$468.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.82
|
| Rate for Payer: BCN Commercial |
$1,457.23
|
| Rate for Payer: BCN Medicare Advantage |
$468.56
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.56
|
| Rate for Payer: Healthscope Commercial |
$1,686.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$491.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$538.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: PACE Senior Care Partners |
$445.13
|
| Rate for Payer: PACE SWMI |
$468.56
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: PHP Medicare Advantage |
$468.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.26
|
| Rate for Payer: Priority Health HMO/PPO |
$1,630.60
|
| Rate for Payer: Priority Health Medicare |
$473.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.75
|
| Rate for Payer: Railroad Medicare Medicare |
$468.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.34
|
| Rate for Payer: UHC Core |
$1,565.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.56
|
| Rate for Payer: UHC Exchange |
$468.56
|
| Rate for Payer: UHC Medicare Advantage |
$468.56
|
| Rate for Payer: VA VA |
$468.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
IP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.26 |
| Max. Negotiated Rate |
$1,686.82 |
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.95
|
| Rate for Payer: BCN Commercial |
$1,448.42
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,686.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.88
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.26
|
| Rate for Payer: Priority Health HMO/PPO |
$1,630.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,649.34
|
| Rate for Payer: UHC Core |
$1,565.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$144.58 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.20
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS MAPPO |
$40.16
|
| Rate for Payer: BCBS Trust/PPO |
$132.07
|
| Rate for Payer: BCN Commercial |
$124.91
|
| Rate for Payer: BCN Medicare Advantage |
$40.16
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.16
|
| Rate for Payer: Healthscope Commercial |
$144.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: PACE Senior Care Partners |
$38.15
|
| Rate for Payer: PACE SWMI |
$40.16
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Medicare |
$40.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.64
|
| Rate for Payer: Railroad Medicare Medicare |
$40.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.16
|
| Rate for Payer: UHC Exchange |
$40.16
|
| Rate for Payer: UHC Medicare Advantage |
$40.16
|
| Rate for Payer: VA VA |
$40.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
IP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.42 |
| Max. Negotiated Rate |
$144.58 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: BCBS Trust/PPO |
$131.14
|
| Rate for Payer: BCN Commercial |
$124.15
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$144.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.27 |
| Max. Negotiated Rate |
$433.76 |
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: BCBS Trust/PPO |
$393.42
|
| Rate for Payer: BCN Commercial |
$372.45
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$433.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: Priority Health HMO/PPO |
$419.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.12
|
| Rate for Payer: UHC Core |
$402.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.46 |
| Max. Negotiated Rate |
$433.76 |
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: Aetna Medicare |
$125.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.61
|
| Rate for Payer: BCBS Complete |
$192.78
|
| Rate for Payer: BCBS MAPPO |
$120.49
|
| Rate for Payer: BCBS Trust/PPO |
$396.21
|
| Rate for Payer: BCN Commercial |
$374.72
|
| Rate for Payer: BCN Medicare Advantage |
$120.49
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.49
|
| Rate for Payer: Healthscope Commercial |
$433.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: Nomi Health Commercial |
$395.20
|
| Rate for Payer: PACE Senior Care Partners |
$114.46
|
| Rate for Payer: PACE SWMI |
$120.49
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: PHP Medicare Advantage |
$120.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: Priority Health HMO/PPO |
$419.30
|
| Rate for Payer: Priority Health Medicare |
$121.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.91
|
| Rate for Payer: Railroad Medicare Medicare |
$120.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.12
|
| Rate for Payer: UHC Core |
$402.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.49
|
| Rate for Payer: UHC Exchange |
$120.49
|
| Rate for Payer: UHC Medicare Advantage |
$120.49
|
| Rate for Payer: VA VA |
$120.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,538.49 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,932.11
|
| Rate for Payer: BCN Commercial |
$1,829.15
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: Priority Health HMO/PPO |
$2,059.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,585.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,082.88
|
| Rate for Payer: UHC Core |
$1,976.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.14 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: Aetna Medicare |
$615.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$739.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$739.66
|
| Rate for Payer: BCBS Complete |
$946.76
|
| Rate for Payer: BCBS MAPPO |
$591.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,945.84
|
| Rate for Payer: BCN Commercial |
$1,840.27
|
| Rate for Payer: BCN Medicare Advantage |
$591.73
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.73
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$680.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: Nomi Health Commercial |
$1,940.87
|
| Rate for Payer: PACE Senior Care Partners |
$562.14
|
| Rate for Payer: PACE SWMI |
$591.73
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: PHP Medicare Advantage |
$591.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: Priority Health HMO/PPO |
$2,059.21
|
| Rate for Payer: Priority Health Medicare |
$597.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,585.83
|
| Rate for Payer: Railroad Medicare Medicare |
$591.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,082.88
|
| Rate for Payer: UHC Core |
$1,976.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.73
|
| Rate for Payer: UHC Exchange |
$591.73
|
| Rate for Payer: UHC Medicare Advantage |
$591.73
|
| Rate for Payer: VA VA |
$591.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,219.47 |
| Max. Negotiated Rate |
$15,534.65 |
| Rate for Payer: Aetna Commercial |
$14,671.61
|
| Rate for Payer: BCBS Trust/PPO |
$14,089.93
|
| Rate for Payer: BCN Commercial |
$13,339.08
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$14,844.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Healthscope Commercial |
$15,534.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,945.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: PHP Commercial |
$14,671.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: Priority Health HMO/PPO |
$15,016.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,564.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,189.43
|
| Rate for Payer: UHC Core |
$14,412.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,945.54
|
|
