|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$109.35
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.28 |
| Max. Negotiated Rate |
$98.42 |
| Rate for Payer: Aetna Commercial |
$92.95
|
| Rate for Payer: Aetna Medicare |
$28.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.17
|
| Rate for Payer: BCBS Complete |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$27.34
|
| Rate for Payer: BCBS Trust/PPO |
$89.90
|
| Rate for Payer: BCN Commercial |
$89.90
|
| Rate for Payer: BCN Medicare Advantage |
$27.34
|
| Rate for Payer: Cash Price |
$87.48
|
| Rate for Payer: Cofinity Commercial |
$94.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$98.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.01
|
| Rate for Payer: Mclaren Medicaid |
$19.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.70
|
| Rate for Payer: Meridian Medicaid |
$20.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Nomi Health Commercial |
$89.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.01
|
| Rate for Payer: PACE Senior Care Partners |
$25.97
|
| Rate for Payer: PACE SWMI |
$27.34
|
| Rate for Payer: PHP Commercial |
$92.95
|
| Rate for Payer: PHP Medicare Advantage |
$27.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.13
|
| Rate for Payer: Priority Health Medicare |
$27.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.11
|
| Rate for Payer: Railroad Medicare Medicare |
$27.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.23
|
| Rate for Payer: UHC Core |
$91.31
|
| Rate for Payer: UHC Exchange |
$27.34
|
| Rate for Payer: UHC Medicaid |
$19.28
|
| Rate for Payer: UHC Medicare Advantage |
$27.34
|
| Rate for Payer: UHCCP Medicaid |
$19.28
|
| Rate for Payer: VA VA |
$27.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.01
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
IP
|
$109.35
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$76.11 |
| Max. Negotiated Rate |
$98.42 |
| Rate for Payer: Aetna Commercial |
$92.95
|
| Rate for Payer: BCBS Trust/PPO |
$90.31
|
| Rate for Payer: BCN Commercial |
$90.31
|
| Rate for Payer: Cash Price |
$87.48
|
| Rate for Payer: Cofinity Commercial |
$94.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.48
|
| Rate for Payer: Healthscope Commercial |
$98.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.95
|
| Rate for Payer: Nomi Health Commercial |
$89.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.01
|
| Rate for Payer: PHP Commercial |
$92.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.23
|
| Rate for Payer: UHC Core |
$91.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.01
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$11.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$12.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicaid |
$11.92
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$11.92
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.86
|
| Rate for Payer: BCN Commercial |
$55.86
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
OP
|
$689.79
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna Medicare |
$179.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.56
|
| Rate for Payer: BCBS Complete |
$127.68
|
| Rate for Payer: BCBS MAPPO |
$172.45
|
| Rate for Payer: BCBS Trust/PPO |
$567.08
|
| Rate for Payer: BCN Commercial |
$567.08
|
| Rate for Payer: BCN Medicare Advantage |
$172.45
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.45
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Mclaren Medicaid |
$121.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.07
|
| Rate for Payer: Meridian Medicaid |
$127.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$565.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PACE Senior Care Partners |
$163.83
|
| Rate for Payer: PACE SWMI |
$172.45
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: PHP Medicare Advantage |
$172.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$600.12
|
| Rate for Payer: Priority Health Medicare |
$174.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.09
|
| Rate for Payer: Railroad Medicare Medicare |
$172.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.02
|
| Rate for Payer: UHC Core |
$575.97
|
| Rate for Payer: UHC Exchange |
$172.45
|
| Rate for Payer: UHC Medicaid |
$121.61
|
| Rate for Payer: UHC Medicare Advantage |
$172.45
|
| Rate for Payer: UHCCP Medicaid |
$121.61
|
| Rate for Payer: VA VA |
$172.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
IP
|
$689.79
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.09 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: BCBS Trust/PPO |
$569.70
|
| Rate for Payer: BCN Commercial |
$569.70
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$565.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$600.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.02
|
| Rate for Payer: UHC Core |
$575.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
IP
|
$588.03
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.27 |
| Max. Negotiated Rate |
$529.23 |
| Rate for Payer: Aetna Commercial |
$499.83
|
| Rate for Payer: BCBS Trust/PPO |
$485.65
|
| Rate for Payer: BCN Commercial |
$485.65
|
| Rate for Payer: Cash Price |
$470.42
|
| Rate for Payer: Cofinity Commercial |
$505.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.42
|
| Rate for Payer: Healthscope Commercial |
$529.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.83
|
| Rate for Payer: Nomi Health Commercial |
$482.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$441.02
|
| Rate for Payer: PHP Commercial |
$499.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.47
|
| Rate for Payer: UHC Core |
$491.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.02
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
OP
|
$588.03
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$103.67 |
| Max. Negotiated Rate |
$529.23 |
| Rate for Payer: Aetna Commercial |
$499.83
|
| Rate for Payer: Aetna Medicare |
$152.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.76
|
| Rate for Payer: BCBS Complete |
$108.84
|
| Rate for Payer: BCBS MAPPO |
$147.01
|
| Rate for Payer: BCBS Trust/PPO |
$483.42
|
| Rate for Payer: BCN Commercial |
$483.42
|
| Rate for Payer: BCN Medicare Advantage |
$147.01
|
| Rate for Payer: Cash Price |
$470.42
|
| Rate for Payer: Cofinity Commercial |
$505.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.01
|
| Rate for Payer: Healthscope Commercial |
$529.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.02
|
| Rate for Payer: Mclaren Medicaid |
$103.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.36
|
| Rate for Payer: Meridian Medicaid |
$108.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.83
|
| Rate for Payer: Nomi Health Commercial |
$482.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$441.02
|
| Rate for Payer: PACE Senior Care Partners |
$139.66
|
| Rate for Payer: PACE SWMI |
$147.01
|
| Rate for Payer: PHP Commercial |
$499.83
|
| Rate for Payer: PHP Medicare Advantage |
$147.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.59
|
| Rate for Payer: Priority Health Medicare |
$148.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.27
|
| Rate for Payer: Railroad Medicare Medicare |
$147.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.47
|
| Rate for Payer: UHC Core |
$491.01
|
| Rate for Payer: UHC Exchange |
$147.01
|
| Rate for Payer: UHC Medicaid |
$103.67
|
| Rate for Payer: UHC Medicare Advantage |
$147.01
|
| Rate for Payer: UHCCP Medicaid |
$103.67
|
| Rate for Payer: VA VA |
$147.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.02
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
OP
|
$5,937.84
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,046.84 |
| Max. Negotiated Rate |
$5,344.06 |
| Rate for Payer: Aetna Commercial |
$5,047.16
|
| Rate for Payer: Aetna Medicare |
$1,543.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,855.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,855.58
|
| Rate for Payer: BCBS Complete |
$1,099.09
|
| Rate for Payer: BCBS MAPPO |
$1,484.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,881.50
|
| Rate for Payer: BCN Commercial |
$4,881.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.46
|
| Rate for Payer: Cash Price |
$4,750.27
|
| Rate for Payer: Cofinity Commercial |
$5,106.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,750.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.46
|
| Rate for Payer: Healthscope Commercial |
$5,344.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,453.38
|
| Rate for Payer: Mclaren Medicaid |
$1,046.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,558.68
|
| Rate for Payer: Meridian Medicaid |
$1,099.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,707.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,632.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,047.16
|
| Rate for Payer: Nomi Health Commercial |
$4,869.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,453.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,410.24
|
| Rate for Payer: PACE SWMI |
$1,484.46
|
| Rate for Payer: PHP Commercial |
$5,047.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,165.92
|
| Rate for Payer: Priority Health Medicare |
$1,499.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,132.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,484.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,225.30
|
| Rate for Payer: UHC Core |
$4,958.10
|
| Rate for Payer: UHC Exchange |
$1,484.46
|
| Rate for Payer: UHC Medicaid |
$1,046.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.46
|
| Rate for Payer: UHCCP Medicaid |
$1,046.84
|
| Rate for Payer: VA VA |
$1,484.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,453.38
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
IP
|
$5,937.84
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,132.74 |
| Max. Negotiated Rate |
$5,344.06 |
| Rate for Payer: Aetna Commercial |
$5,047.16
|
| Rate for Payer: BCBS Trust/PPO |
$4,904.06
|
| Rate for Payer: BCN Commercial |
$4,904.06
|
| Rate for Payer: Cash Price |
$4,750.27
|
| Rate for Payer: Cofinity Commercial |
$5,106.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,750.27
|
| Rate for Payer: Healthscope Commercial |
$5,344.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,453.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,047.16
|
| Rate for Payer: Nomi Health Commercial |
$4,869.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,453.38
|
| Rate for Payer: PHP Commercial |
$5,047.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,165.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,132.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,225.30
|
| Rate for Payer: UHC Core |
$4,958.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,453.38
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
OP
|
$10,560.06
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,861.74 |
| Max. Negotiated Rate |
$9,504.05 |
| Rate for Payer: Aetna Commercial |
$8,976.05
|
| Rate for Payer: Aetna Medicare |
$2,745.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,300.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,300.02
|
| Rate for Payer: BCBS Complete |
$1,954.67
|
| Rate for Payer: BCBS MAPPO |
$2,640.01
|
| Rate for Payer: BCBS Trust/PPO |
$8,681.43
|
| Rate for Payer: BCN Commercial |
$8,681.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,640.01
|
| Rate for Payer: Cash Price |
$8,448.05
|
| Rate for Payer: Cofinity Commercial |
$9,081.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,448.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,640.01
|
| Rate for Payer: Healthscope Commercial |
$9,504.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,920.05
|
| Rate for Payer: Mclaren Medicaid |
$1,861.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,772.02
|
| Rate for Payer: Meridian Medicaid |
$1,954.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,036.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,904.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,976.05
|
| Rate for Payer: Nomi Health Commercial |
$8,659.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,920.05
|
| Rate for Payer: PACE Senior Care Partners |
$2,508.01
|
| Rate for Payer: PACE SWMI |
$2,640.01
|
| Rate for Payer: PHP Commercial |
$8,976.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,640.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,861.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,187.25
|
| Rate for Payer: Priority Health Medicare |
$2,666.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,349.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,640.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,292.85
|
| Rate for Payer: UHC Core |
$8,817.65
|
| Rate for Payer: UHC Exchange |
$2,640.01
|
| Rate for Payer: UHC Medicaid |
$1,861.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,640.01
|
| Rate for Payer: UHCCP Medicaid |
$1,861.74
|
| Rate for Payer: VA VA |
$2,640.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,920.05
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
IP
|
$10,560.06
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,349.80 |
| Max. Negotiated Rate |
$9,504.05 |
| Rate for Payer: Aetna Commercial |
$8,976.05
|
| Rate for Payer: BCBS Trust/PPO |
$8,721.55
|
| Rate for Payer: BCN Commercial |
$8,721.55
|
| Rate for Payer: Cash Price |
$8,448.05
|
| Rate for Payer: Cofinity Commercial |
$9,081.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,448.05
|
| Rate for Payer: Healthscope Commercial |
$9,504.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,920.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,976.05
|
| Rate for Payer: Nomi Health Commercial |
$8,659.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,920.05
|
| Rate for Payer: PHP Commercial |
$8,976.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,187.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,349.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,292.85
|
| Rate for Payer: UHC Core |
$8,817.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,920.05
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$13,517.92
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,408.47 |
| Max. Negotiated Rate |
$12,166.13 |
| Rate for Payer: Aetna Commercial |
$11,490.23
|
| Rate for Payer: BCBS Trust/PPO |
$11,164.45
|
| Rate for Payer: BCN Commercial |
$11,164.45
|
| Rate for Payer: Cash Price |
$10,814.34
|
| Rate for Payer: Cofinity Commercial |
$11,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,814.34
|
| Rate for Payer: Healthscope Commercial |
$12,166.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,138.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,490.23
|
| Rate for Payer: Nomi Health Commercial |
$11,084.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,138.44
|
| Rate for Payer: PHP Commercial |
$11,490.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,760.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,408.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,895.77
|
| Rate for Payer: UHC Core |
$11,287.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,138.44
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
OP
|
$13,517.92
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,383.21 |
| Max. Negotiated Rate |
$12,166.13 |
| Rate for Payer: Aetna Commercial |
$11,490.23
|
| Rate for Payer: Aetna Medicare |
$3,514.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.35
|
| Rate for Payer: BCBS Complete |
$2,502.17
|
| Rate for Payer: BCBS MAPPO |
$3,379.48
|
| Rate for Payer: BCBS Trust/PPO |
$11,113.08
|
| Rate for Payer: BCN Commercial |
$11,113.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.48
|
| Rate for Payer: Cash Price |
$10,814.34
|
| Rate for Payer: Cofinity Commercial |
$11,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,814.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.48
|
| Rate for Payer: Healthscope Commercial |
$12,166.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,138.44
|
| Rate for Payer: Mclaren Medicaid |
$2,383.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.45
|
| Rate for Payer: Meridian Medicaid |
$2,502.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,717.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,490.23
|
| Rate for Payer: Nomi Health Commercial |
$11,084.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,138.44
|
| Rate for Payer: PACE Senior Care Partners |
$3,210.51
|
| Rate for Payer: PACE SWMI |
$3,379.48
|
| Rate for Payer: PHP Commercial |
$11,490.23
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,383.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,760.59
|
| Rate for Payer: Priority Health Medicare |
$3,413.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,408.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,895.77
|
| Rate for Payer: UHC Core |
$11,287.46
|
| Rate for Payer: UHC Exchange |
$3,379.48
|
| Rate for Payer: UHC Medicaid |
$2,383.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.48
|
| Rate for Payer: UHCCP Medicaid |
$2,383.21
|
| Rate for Payer: VA VA |
$3,379.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,138.44
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
IP
|
$545.27
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$379.51 |
| Max. Negotiated Rate |
$490.74 |
| Rate for Payer: Aetna Commercial |
$463.48
|
| Rate for Payer: BCBS Trust/PPO |
$450.34
|
| Rate for Payer: BCN Commercial |
$450.34
|
| Rate for Payer: Cash Price |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$468.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.22
|
| Rate for Payer: Healthscope Commercial |
$490.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.48
|
| Rate for Payer: Nomi Health Commercial |
$447.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.95
|
| Rate for Payer: PHP Commercial |
$463.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$474.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.84
|
| Rate for Payer: UHC Core |
$455.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.95
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
OP
|
$545.27
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$96.13 |
| Max. Negotiated Rate |
$490.74 |
| Rate for Payer: Aetna Commercial |
$463.48
|
| Rate for Payer: Aetna Medicare |
$141.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.40
|
| Rate for Payer: BCBS Complete |
$100.93
|
| Rate for Payer: BCBS MAPPO |
$136.32
|
| Rate for Payer: BCBS Trust/PPO |
$448.27
|
| Rate for Payer: BCN Commercial |
$448.27
|
| Rate for Payer: BCN Medicare Advantage |
$136.32
|
| Rate for Payer: Cash Price |
$436.22
|
| Rate for Payer: Cofinity Commercial |
$468.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.32
|
| Rate for Payer: Healthscope Commercial |
$490.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.95
|
| Rate for Payer: Mclaren Medicaid |
$96.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.13
|
| Rate for Payer: Meridian Medicaid |
$100.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.48
|
| Rate for Payer: Nomi Health Commercial |
$447.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$408.95
|
| Rate for Payer: PACE Senior Care Partners |
$129.50
|
| Rate for Payer: PACE SWMI |
$136.32
|
| Rate for Payer: PHP Commercial |
$463.48
|
| Rate for Payer: PHP Medicare Advantage |
$136.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$474.38
|
| Rate for Payer: Priority Health Medicare |
$137.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.51
|
| Rate for Payer: Railroad Medicare Medicare |
$136.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.84
|
| Rate for Payer: UHC Core |
$455.30
|
| Rate for Payer: UHC Exchange |
$136.32
|
| Rate for Payer: UHC Medicaid |
$96.13
|
| Rate for Payer: UHC Medicare Advantage |
$136.32
|
| Rate for Payer: UHCCP Medicaid |
$96.13
|
| Rate for Payer: VA VA |
$136.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.95
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
IP
|
$1,787.98
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,244.43 |
| Max. Negotiated Rate |
$1,609.18 |
| Rate for Payer: Aetna Commercial |
$1,519.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.69
|
| Rate for Payer: BCN Commercial |
$1,476.69
|
| Rate for Payer: Cash Price |
$1,430.38
|
| Rate for Payer: Cofinity Commercial |
$1,537.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.38
|
| Rate for Payer: Healthscope Commercial |
$1,609.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,340.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,519.78
|
| Rate for Payer: Nomi Health Commercial |
$1,466.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.98
|
| Rate for Payer: PHP Commercial |
$1,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,555.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,573.42
|
| Rate for Payer: UHC Core |
$1,492.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,340.98
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
OP
|
$1,787.98
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$315.22 |
| Max. Negotiated Rate |
$1,609.18 |
| Rate for Payer: Aetna Commercial |
$1,519.78
|
| Rate for Payer: Aetna Medicare |
$464.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$558.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$558.74
|
| Rate for Payer: BCBS Complete |
$330.96
|
| Rate for Payer: BCBS MAPPO |
$447.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,469.90
|
| Rate for Payer: BCN Commercial |
$1,469.90
|
| Rate for Payer: BCN Medicare Advantage |
$447.00
|
| Rate for Payer: Cash Price |
$1,430.38
|
| Rate for Payer: Cofinity Commercial |
$1,537.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.00
|
| Rate for Payer: Healthscope Commercial |
$1,609.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,340.98
|
| Rate for Payer: Mclaren Medicaid |
$315.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.34
|
| Rate for Payer: Meridian Medicaid |
$330.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,519.78
|
| Rate for Payer: Nomi Health Commercial |
$1,466.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.98
|
| Rate for Payer: PACE Senior Care Partners |
$424.65
|
| Rate for Payer: PACE SWMI |
$447.00
|
| Rate for Payer: PHP Commercial |
$1,519.78
|
| Rate for Payer: PHP Medicare Advantage |
$447.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,555.54
|
| Rate for Payer: Priority Health Medicare |
$451.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.43
|
| Rate for Payer: Railroad Medicare Medicare |
$447.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,573.42
|
| Rate for Payer: UHC Core |
$1,492.96
|
| Rate for Payer: UHC Exchange |
$447.00
|
| Rate for Payer: UHC Medicaid |
$315.22
|
| Rate for Payer: UHC Medicare Advantage |
$447.00
|
| Rate for Payer: UHCCP Medicaid |
$315.22
|
| Rate for Payer: VA VA |
$447.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,340.98
|
|
|
HC GUIDEWIRE
|
Facility
|
IP
|
$50.37
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.06 |
| Max. Negotiated Rate |
$45.33 |
| Rate for Payer: Aetna Commercial |
$42.81
|
| Rate for Payer: BCBS Trust/PPO |
$41.60
|
| Rate for Payer: BCN Commercial |
$41.60
|
| Rate for Payer: Cash Price |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$43.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.30
|
| Rate for Payer: Healthscope Commercial |
$45.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.81
|
| Rate for Payer: Nomi Health Commercial |
$41.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.78
|
| Rate for Payer: PHP Commercial |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.33
|
| Rate for Payer: UHC Core |
$42.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.78
|
|
|
HC GUIDEWIRE
|
Facility
|
OP
|
$50.37
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.88 |
| Max. Negotiated Rate |
$45.33 |
| Rate for Payer: Aetna Commercial |
$42.81
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.74
|
| Rate for Payer: BCBS Complete |
$9.32
|
| Rate for Payer: BCBS MAPPO |
$12.59
|
| Rate for Payer: BCBS Trust/PPO |
$41.41
|
| Rate for Payer: BCN Commercial |
$41.41
|
| Rate for Payer: BCN Medicare Advantage |
$12.59
|
| Rate for Payer: Cash Price |
$40.30
|
| Rate for Payer: Cofinity Commercial |
$43.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.59
|
| Rate for Payer: Healthscope Commercial |
$45.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.78
|
| Rate for Payer: Mclaren Medicaid |
$8.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.22
|
| Rate for Payer: Meridian Medicaid |
$9.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.81
|
| Rate for Payer: Nomi Health Commercial |
$41.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.78
|
| Rate for Payer: PACE Senior Care Partners |
$11.96
|
| Rate for Payer: PACE SWMI |
$12.59
|
| Rate for Payer: PHP Commercial |
$42.81
|
| Rate for Payer: PHP Medicare Advantage |
$12.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.82
|
| Rate for Payer: Priority Health Medicare |
$12.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.06
|
| Rate for Payer: Railroad Medicare Medicare |
$12.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.33
|
| Rate for Payer: UHC Core |
$42.06
|
| Rate for Payer: UHC Exchange |
$12.59
|
| Rate for Payer: UHC Medicaid |
$8.88
|
| Rate for Payer: UHC Medicare Advantage |
$12.59
|
| Rate for Payer: UHCCP Medicaid |
$8.88
|
| Rate for Payer: VA VA |
$12.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.78
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
IP
|
$1,372.36
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.16 |
| Max. Negotiated Rate |
$1,235.12 |
| Rate for Payer: Aetna Commercial |
$1,166.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.43
|
| Rate for Payer: BCN Commercial |
$1,133.43
|
| Rate for Payer: Cash Price |
$1,097.89
|
| Rate for Payer: Cofinity Commercial |
$1,180.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.89
|
| Rate for Payer: Healthscope Commercial |
$1,235.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.51
|
| Rate for Payer: Nomi Health Commercial |
$1,125.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.27
|
| Rate for Payer: PHP Commercial |
$1,166.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,193.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$955.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,207.68
|
| Rate for Payer: UHC Core |
$1,145.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.27
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
OP
|
$1,372.36
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$241.95 |
| Max. Negotiated Rate |
$1,235.12 |
| Rate for Payer: Aetna Commercial |
$1,166.51
|
| Rate for Payer: Aetna Medicare |
$356.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$428.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$428.86
|
| Rate for Payer: BCBS Complete |
$254.02
|
| Rate for Payer: BCBS MAPPO |
$343.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.22
|
| Rate for Payer: BCN Commercial |
$1,128.22
|
| Rate for Payer: BCN Medicare Advantage |
$343.09
|
| Rate for Payer: Cash Price |
$1,097.89
|
| Rate for Payer: Cofinity Commercial |
$1,180.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.09
|
| Rate for Payer: Healthscope Commercial |
$1,235.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.27
|
| Rate for Payer: Mclaren Medicaid |
$241.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.24
|
| Rate for Payer: Meridian Medicaid |
$254.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$394.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.51
|
| Rate for Payer: Nomi Health Commercial |
$1,125.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.27
|
| Rate for Payer: PACE Senior Care Partners |
$325.94
|
| Rate for Payer: PACE SWMI |
$343.09
|
| Rate for Payer: PHP Commercial |
$1,166.51
|
| Rate for Payer: PHP Medicare Advantage |
$343.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,193.95
|
| Rate for Payer: Priority Health Medicare |
$346.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$955.16
|
| Rate for Payer: Railroad Medicare Medicare |
$343.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,207.68
|
| Rate for Payer: UHC Core |
$1,145.92
|
| Rate for Payer: UHC Exchange |
$343.09
|
| Rate for Payer: UHC Medicaid |
$241.95
|
| Rate for Payer: UHC Medicare Advantage |
$343.09
|
| Rate for Payer: UHCCP Medicaid |
$241.95
|
| Rate for Payer: VA VA |
$343.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.27
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: BCBS Trust/PPO |
$65.71
|
| Rate for Payer: BCN Commercial |
$65.71
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.67
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
