|
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 |
$76.88 |
| Max. Negotiated Rate |
$715.95 |
| Rate for Payer: Aetna Commercial |
$676.17
|
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.82
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.17
|
| 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 |
$676.17
|
| Rate for Payer: PHP Medicare Advantage |
$198.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health HMO/PPO |
$692.09
|
| Rate for Payer: Priority Health Medicare |
$200.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.99
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$198.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.62
|
|
|
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 |
$8,609.76
|
| 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 |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,405.35
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| 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 |
$8,199.23
|
| 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 |
$8,199.23
|
| Rate for Payer: VA VA |
$4,195.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,586.70
|
|
|
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 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 |
$13,632.74
|
| 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 |
$12,982.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,826.42
|
| Rate for Payer: Meridian Medicaid |
$13,632.74
|
| 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 |
$12,982.71
|
| 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 |
$12,982.71
|
| Rate for Payer: VA VA |
$4,596.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,789.76
|
|
|
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 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 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 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 |
$1,686.83 |
| 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 |
$1,686.83
|
| 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 LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.13 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: Aetna Medicare |
$487.31
|
| 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 |
$1,686.83
|
| 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 LVL 1
|
Facility
|
IP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.42 |
| Max. Negotiated Rate |
$144.59 |
| 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 |
$144.59
|
| 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 LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$144.59 |
| 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 |
$144.59
|
| 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 LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.46 |
| Max. Negotiated Rate |
$433.75 |
| 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 |
$433.75
|
| 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 LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.27 |
| Max. Negotiated Rate |
$433.75 |
| 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 |
$433.75
|
| 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 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
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,099.42 |
| Max. Negotiated Rate |
$15,534.65 |
| Rate for Payer: Aetna Commercial |
$14,671.61
|
| Rate for Payer: Aetna Medicare |
$4,487.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,393.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,393.98
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$4,315.18
|
| Rate for Payer: BCBS Trust/PPO |
$14,190.04
|
| Rate for Payer: BCN Commercial |
$13,420.21
|
| Rate for Payer: BCN Medicare Advantage |
$4,315.18
|
| Rate for Payer: Cash Price |
$13,808.58
|
| 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: Health Alliance Plan Medicare Advantage |
$4,315.18
|
| Rate for Payer: Healthscope Commercial |
$15,534.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,945.54
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,530.94
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,962.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: Nomi Health Commercial |
$14,153.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,099.42
|
| Rate for Payer: PACE SWMI |
$4,315.18
|
| Rate for Payer: PHP Commercial |
$14,671.61
|
| Rate for Payer: PHP Medicare Advantage |
$4,315.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| 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 Medicare |
$4,358.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,564.68
|
| Rate for Payer: Railroad Medicare Medicare |
$4,315.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,189.43
|
| Rate for Payer: UHC Core |
$14,412.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,315.18
|
| Rate for Payer: UHC Exchange |
$4,315.18
|
| Rate for Payer: UHC Medicare Advantage |
$4,315.18
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$4,315.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,945.54
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,247.90 |
| Max. Negotiated Rate |
$8,609.76 |
| Rate for Payer: Aetna Commercial |
$4,466.17
|
| Rate for Payer: Aetna Medicare |
$1,366.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,641.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,641.97
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$1,313.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,319.58
|
| Rate for Payer: BCN Commercial |
$4,085.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,313.58
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,518.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,313.58
|
| Rate for Payer: Healthscope Commercial |
$4,728.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,940.74
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,379.26
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,510.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: PACE Senior Care Partners |
$1,247.90
|
| Rate for Payer: PACE SWMI |
$1,313.58
|
| Rate for Payer: PHP Commercial |
$4,466.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,313.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health HMO/PPO |
$4,571.26
|
| Rate for Payer: Priority Health Medicare |
$1,326.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,520.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,313.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,623.80
|
| Rate for Payer: UHC Core |
$4,387.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,313.58
|
| Rate for Payer: UHC Exchange |
$1,313.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,313.58
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$1,313.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,940.74
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,415.31 |
| Max. Negotiated Rate |
$4,728.89 |
| Rate for Payer: Aetna Commercial |
$4,466.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,289.10
|
| Rate for Payer: BCN Commercial |
$4,060.54
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,518.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Healthscope Commercial |
$4,728.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,940.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: Nomi Health Commercial |
$4,308.54
|
| Rate for Payer: PHP Commercial |
$4,466.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health HMO/PPO |
$4,571.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,520.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,623.80
|
| Rate for Payer: UHC Core |
$4,387.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,940.74
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
IP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.69 |
| Max. Negotiated Rate |
$385.88 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: BCBS Trust/PPO |
$350.00
|
| Rate for Payer: BCN Commercial |
$331.35
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health HMO/PPO |
$373.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.31
|
| Rate for Payer: UHC Core |
$358.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.57
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.83 |
| Max. Negotiated Rate |
$385.88 |
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna Medicare |
$111.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.99
|
| Rate for Payer: BCBS Complete |
$171.50
|
| Rate for Payer: BCBS MAPPO |
$107.19
|
| Rate for Payer: BCBS Trust/PPO |
$352.48
|
| Rate for Payer: BCN Commercial |
$333.36
|
| Rate for Payer: BCN Medicare Advantage |
$107.19
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.19
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: Nomi Health Commercial |
$351.58
|
| Rate for Payer: PACE Senior Care Partners |
$101.83
|
| Rate for Payer: PACE SWMI |
$107.19
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: PHP Medicare Advantage |
$107.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health HMO/PPO |
$373.02
|
| Rate for Payer: Priority Health Medicare |
$108.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.27
|
| Rate for Payer: Railroad Medicare Medicare |
$107.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.31
|
| Rate for Payer: UHC Core |
$358.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.19
|
| Rate for Payer: UHC Exchange |
$107.19
|
| Rate for Payer: UHC Medicare Advantage |
$107.19
|
| Rate for Payer: VA VA |
$107.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.57
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,119.73 |
| Max. Negotiated Rate |
$19,401.07 |
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: Aetna Medicare |
$5,604.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,736.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,736.48
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$5,389.19
|
| Rate for Payer: BCBS Trust/PPO |
$17,721.80
|
| Rate for Payer: BCN Commercial |
$16,760.37
|
| Rate for Payer: BCN Medicare Advantage |
$5,389.19
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,389.19
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,167.56
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,658.64
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,197.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: PACE Senior Care Partners |
$5,119.73
|
| Rate for Payer: PACE SWMI |
$5,389.19
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: PHP Medicare Advantage |
$5,389.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health HMO/PPO |
$18,754.36
|
| Rate for Payer: Priority Health Medicare |
$5,443.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,443.02
|
| Rate for Payer: Railroad Medicare Medicare |
$5,389.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,969.93
|
| Rate for Payer: UHC Core |
$17,999.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,389.19
|
| Rate for Payer: UHC Exchange |
$5,389.19
|
| Rate for Payer: UHC Medicare Advantage |
$5,389.19
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$5,389.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,167.56
|
|
|
HC EMBOLIZATION VENOUS OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$21,556.74
|
|
|
Service Code
|
CPT 37241
|
| Hospital Charge Code |
36100428
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,011.88 |
| Max. Negotiated Rate |
$19,401.07 |
| Rate for Payer: Aetna Commercial |
$18,323.23
|
| Rate for Payer: BCBS Trust/PPO |
$17,596.77
|
| Rate for Payer: BCN Commercial |
$16,659.05
|
| Rate for Payer: Cash Price |
$17,245.39
|
| Rate for Payer: Cofinity Commercial |
$18,538.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,245.39
|
| Rate for Payer: Healthscope Commercial |
$19,401.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,167.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,323.23
|
| Rate for Payer: Nomi Health Commercial |
$17,676.53
|
| Rate for Payer: PHP Commercial |
$18,323.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,011.88
|
| Rate for Payer: Priority Health HMO/PPO |
$18,754.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,443.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,969.93
|
| Rate for Payer: UHC Core |
$17,999.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,167.56
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
OP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,401.82 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: Aetna Medicare |
$1,534.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,844.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,844.50
|
| Rate for Payer: BCBS Complete |
$2,360.96
|
| Rate for Payer: BCBS MAPPO |
$1,475.60
|
| Rate for Payer: BCBS Trust/PPO |
$4,852.37
|
| Rate for Payer: BCN Commercial |
$4,589.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,475.60
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,475.60
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,426.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,549.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,696.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: PACE Senior Care Partners |
$1,401.82
|
| Rate for Payer: PACE SWMI |
$1,475.60
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,475.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health HMO/PPO |
$5,135.10
|
| Rate for Payer: Priority Health Medicare |
$1,490.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,954.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,475.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,194.12
|
| Rate for Payer: UHC Core |
$4,928.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,475.60
|
| Rate for Payer: UHC Exchange |
$1,475.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,475.60
|
| Rate for Payer: VA VA |
$1,475.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,426.81
|
|
|
HC EMBOSHIELD SYSTEM
|
Facility
|
IP
|
$5,902.41
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800010
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,836.57 |
| Max. Negotiated Rate |
$5,312.17 |
| Rate for Payer: Aetna Commercial |
$5,017.05
|
| Rate for Payer: BCBS Trust/PPO |
$4,818.14
|
| Rate for Payer: BCN Commercial |
$4,561.38
|
| Rate for Payer: Cash Price |
$4,721.93
|
| Rate for Payer: Cofinity Commercial |
$5,076.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,721.93
|
| Rate for Payer: Healthscope Commercial |
$5,312.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,426.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,017.05
|
| Rate for Payer: Nomi Health Commercial |
$4,839.98
|
| Rate for Payer: PHP Commercial |
$5,017.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.57
|
| Rate for Payer: Priority Health HMO/PPO |
$5,135.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,954.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,194.12
|
| Rate for Payer: UHC Core |
$4,928.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,426.81
|
|
