|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.86
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCBS Trust/PPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$65.41
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| 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: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.88
|
| 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: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Medicare |
$20.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: UHC Exchange |
$19.89
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$260.04 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: Aetna Medicare |
$383.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$460.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$460.94
|
| Rate for Payer: BCBS Complete |
$273.02
|
| Rate for Payer: BCBS MAPPO |
$368.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.60
|
| Rate for Payer: BCN Commercial |
$1,212.60
|
| Rate for Payer: BCN Medicare Advantage |
$368.75
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.75
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.25
|
| Rate for Payer: Mclaren Medicaid |
$260.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.19
|
| Rate for Payer: Meridian Medicaid |
$273.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$405.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: PACE Senior Care Partners |
$350.31
|
| Rate for Payer: PACE SWMI |
$368.75
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: PHP Medicare Advantage |
$368.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,283.25
|
| Rate for Payer: Priority Health Medicare |
$372.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.60
|
| Rate for Payer: Railroad Medicare Medicare |
$368.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.00
|
| Rate for Payer: UHC Core |
$1,231.62
|
| Rate for Payer: UHC Exchange |
$368.75
|
| Rate for Payer: UHC Medicaid |
$260.04
|
| Rate for Payer: UHC Medicare Advantage |
$368.75
|
| Rate for Payer: UHCCP Medicaid |
$260.04
|
| Rate for Payer: VA VA |
$368.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.25
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,026.60 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.20
|
| Rate for Payer: BCN Commercial |
$1,218.20
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,283.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.00
|
| Rate for Payer: UHC Core |
$1,231.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.25
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
IP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$225.86 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: BCBS Trust/PPO |
$268.01
|
| Rate for Payer: BCN Commercial |
$268.01
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$282.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.57
|
| Rate for Payer: UHC Core |
$270.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.38
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
OP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.21 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: Aetna Medicare |
$84.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.41
|
| Rate for Payer: BCBS Complete |
$60.07
|
| Rate for Payer: BCBS MAPPO |
$81.13
|
| Rate for Payer: BCBS Trust/PPO |
$266.78
|
| Rate for Payer: BCN Commercial |
$266.78
|
| Rate for Payer: BCN Medicare Advantage |
$81.13
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.13
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.38
|
| Rate for Payer: Mclaren Medicaid |
$57.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.18
|
| Rate for Payer: Meridian Medicaid |
$60.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.38
|
| Rate for Payer: PACE Senior Care Partners |
$77.07
|
| Rate for Payer: PACE SWMI |
$81.13
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: PHP Medicare Advantage |
$81.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$282.32
|
| Rate for Payer: Priority Health Medicare |
$81.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.86
|
| Rate for Payer: Railroad Medicare Medicare |
$81.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.57
|
| Rate for Payer: UHC Core |
$270.97
|
| Rate for Payer: UHC Exchange |
$81.13
|
| Rate for Payer: UHC Medicaid |
$57.21
|
| Rate for Payer: UHC Medicare Advantage |
$81.13
|
| Rate for Payer: UHCCP Medicaid |
$57.21
|
| Rate for Payer: VA VA |
$81.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.38
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
OP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.46 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: Aetna Medicare |
$120.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.39
|
| Rate for Payer: BCBS Complete |
$85.53
|
| Rate for Payer: BCBS MAPPO |
$115.52
|
| Rate for Payer: BCBS Trust/PPO |
$379.86
|
| Rate for Payer: BCN Commercial |
$379.86
|
| Rate for Payer: BCN Medicare Advantage |
$115.52
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.52
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.55
|
| Rate for Payer: Mclaren Medicaid |
$81.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.29
|
| Rate for Payer: Meridian Medicaid |
$85.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: PACE Senior Care Partners |
$109.74
|
| Rate for Payer: PACE SWMI |
$115.52
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: PHP Medicare Advantage |
$115.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.99
|
| Rate for Payer: Priority Health Medicare |
$116.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.59
|
| Rate for Payer: Railroad Medicare Medicare |
$115.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.61
|
| Rate for Payer: UHC Core |
$385.82
|
| Rate for Payer: UHC Exchange |
$115.52
|
| Rate for Payer: UHC Medicaid |
$81.46
|
| Rate for Payer: UHC Medicare Advantage |
$115.52
|
| Rate for Payer: UHCCP Medicaid |
$81.46
|
| Rate for Payer: VA VA |
$115.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.55
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
IP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.59 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: BCBS Trust/PPO |
$381.62
|
| Rate for Payer: BCN Commercial |
$381.62
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.55
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.61
|
| Rate for Payer: UHC Core |
$385.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.55
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
IP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$467.47 |
| Max. Negotiated Rate |
$604.49 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: BCBS Trust/PPO |
$554.72
|
| Rate for Payer: BCN Commercial |
$554.72
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$604.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$584.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$467.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.05
|
| Rate for Payer: UHC Core |
$560.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.74
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
OP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.41 |
| Max. Negotiated Rate |
$604.49 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: Aetna Medicare |
$174.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.89
|
| Rate for Payer: BCBS Complete |
$124.32
|
| Rate for Payer: BCBS MAPPO |
$167.91
|
| Rate for Payer: BCBS Trust/PPO |
$552.16
|
| Rate for Payer: BCN Commercial |
$552.16
|
| Rate for Payer: BCN Medicare Advantage |
$167.91
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.91
|
| Rate for Payer: Healthscope Commercial |
$604.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.74
|
| Rate for Payer: Mclaren Medicaid |
$118.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.31
|
| Rate for Payer: Meridian Medicaid |
$124.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.74
|
| Rate for Payer: PACE Senior Care Partners |
$159.52
|
| Rate for Payer: PACE SWMI |
$167.91
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: PHP Medicare Advantage |
$167.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$584.34
|
| Rate for Payer: Priority Health Medicare |
$169.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$467.47
|
| Rate for Payer: Railroad Medicare Medicare |
$167.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.05
|
| Rate for Payer: UHC Core |
$560.83
|
| Rate for Payer: UHC Exchange |
$167.91
|
| Rate for Payer: UHC Medicaid |
$118.41
|
| Rate for Payer: UHC Medicare Advantage |
$167.91
|
| Rate for Payer: UHCCP Medicaid |
$118.41
|
| Rate for Payer: VA VA |
$167.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.74
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
IP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: BCBS Trust/PPO |
$36.25
|
| Rate for Payer: BCN Commercial |
$36.25
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.62
|
| Rate for Payer: UHC Core |
$36.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.92
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
OP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.74 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: Aetna Medicare |
$11.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$8.12
|
| Rate for Payer: BCBS MAPPO |
$10.97
|
| Rate for Payer: BCBS Trust/PPO |
$36.08
|
| Rate for Payer: BCN Commercial |
$36.08
|
| Rate for Payer: BCN Medicare Advantage |
$10.97
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.97
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.92
|
| Rate for Payer: Mclaren Medicaid |
$7.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.52
|
| Rate for Payer: Meridian Medicaid |
$8.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.92
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.97
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: PHP Medicare Advantage |
$10.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.18
|
| Rate for Payer: Priority Health Medicare |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.62
|
| Rate for Payer: UHC Core |
$36.65
|
| Rate for Payer: UHC Exchange |
$10.97
|
| Rate for Payer: UHC Medicaid |
$7.74
|
| Rate for Payer: UHC Medicare Advantage |
$10.97
|
| Rate for Payer: UHCCP Medicaid |
$7.74
|
| Rate for Payer: VA VA |
$10.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.92
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
OP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$315.40 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Aetna Medicare |
$465.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$559.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$559.07
|
| Rate for Payer: BCBS Complete |
$331.15
|
| Rate for Payer: BCBS MAPPO |
$447.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.75
|
| Rate for Payer: BCN Commercial |
$1,470.75
|
| Rate for Payer: BCN Medicare Advantage |
$447.25
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.25
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.76
|
| Rate for Payer: Mclaren Medicaid |
$315.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.62
|
| Rate for Payer: Meridian Medicaid |
$331.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: PACE Senior Care Partners |
$424.89
|
| Rate for Payer: PACE SWMI |
$447.25
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: PHP Medicare Advantage |
$447.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,556.44
|
| Rate for Payer: Priority Health Medicare |
$451.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,245.15
|
| Rate for Payer: Railroad Medicare Medicare |
$447.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.33
|
| Rate for Payer: UHC Core |
$1,493.82
|
| Rate for Payer: UHC Exchange |
$447.25
|
| Rate for Payer: UHC Medicaid |
$315.40
|
| Rate for Payer: UHC Medicare Advantage |
$447.25
|
| Rate for Payer: UHCCP Medicaid |
$315.40
|
| Rate for Payer: VA VA |
$447.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.76
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
IP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,245.15 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.54
|
| Rate for Payer: BCN Commercial |
$1,477.54
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,341.76
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,556.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,245.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.33
|
| Rate for Payer: UHC Core |
$1,493.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.76
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
OP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$348.79 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: Aetna Medicare |
$514.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$618.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$618.24
|
| Rate for Payer: BCBS Complete |
$366.20
|
| Rate for Payer: BCBS MAPPO |
$494.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.42
|
| Rate for Payer: BCN Commercial |
$1,626.42
|
| Rate for Payer: BCN Medicare Advantage |
$494.59
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.59
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.78
|
| Rate for Payer: Mclaren Medicaid |
$348.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.32
|
| Rate for Payer: Meridian Medicaid |
$366.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$568.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$544.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: PACE Senior Care Partners |
$469.86
|
| Rate for Payer: PACE SWMI |
$494.59
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: PHP Medicare Advantage |
$494.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,721.18
|
| Rate for Payer: Priority Health Medicare |
$499.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,376.95
|
| Rate for Payer: Railroad Medicare Medicare |
$494.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.97
|
| Rate for Payer: UHC Core |
$1,651.94
|
| Rate for Payer: UHC Exchange |
$494.59
|
| Rate for Payer: UHC Medicaid |
$348.79
|
| Rate for Payer: UHC Medicare Advantage |
$494.59
|
| Rate for Payer: UHCCP Medicaid |
$348.79
|
| Rate for Payer: VA VA |
$494.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.78
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
IP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,376.95 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,633.94
|
| Rate for Payer: BCN Commercial |
$1,633.94
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,483.78
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,721.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,376.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.97
|
| Rate for Payer: UHC Core |
$1,651.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.78
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
IP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.05 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: BCBS Trust/PPO |
$236.20
|
| Rate for Payer: BCN Commercial |
$236.20
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.67
|
| Rate for Payer: UHC Core |
$238.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
OP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.42 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: Aetna Medicare |
$74.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.37
|
| Rate for Payer: BCBS Complete |
$52.94
|
| Rate for Payer: BCBS MAPPO |
$71.50
|
| Rate for Payer: BCBS Trust/PPO |
$235.11
|
| Rate for Payer: BCN Commercial |
$235.11
|
| Rate for Payer: BCN Medicare Advantage |
$71.50
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.50
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Mclaren Medicaid |
$50.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.07
|
| Rate for Payer: Meridian Medicaid |
$52.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.49
|
| Rate for Payer: PACE Senior Care Partners |
$67.92
|
| Rate for Payer: PACE SWMI |
$71.50
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: PHP Medicare Advantage |
$71.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.81
|
| Rate for Payer: Priority Health Medicare |
$72.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.05
|
| Rate for Payer: Railroad Medicare Medicare |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.67
|
| Rate for Payer: UHC Core |
$238.80
|
| Rate for Payer: UHC Exchange |
$71.50
|
| Rate for Payer: UHC Medicaid |
$50.42
|
| Rate for Payer: UHC Medicare Advantage |
$71.50
|
| Rate for Payer: UHCCP Medicaid |
$50.42
|
| Rate for Payer: VA VA |
$71.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
OP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.56 |
| Max. Negotiated Rate |
$2,274.54 |
| Rate for Payer: Aetna Commercial |
$2,148.18
|
| Rate for Payer: Aetna Medicare |
$657.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$789.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$789.77
|
| Rate for Payer: BCBS Complete |
$467.80
|
| Rate for Payer: BCBS MAPPO |
$631.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.67
|
| Rate for Payer: BCN Commercial |
$2,077.67
|
| Rate for Payer: BCN Medicare Advantage |
$631.82
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Commercial |
$2,173.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$631.82
|
| Rate for Payer: Healthscope Commercial |
$2,274.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,895.45
|
| Rate for Payer: Mclaren Medicaid |
$445.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.41
|
| Rate for Payer: Meridian Medicaid |
$467.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$726.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$695.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Nomi Health Commercial |
$2,072.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: PACE Senior Care Partners |
$600.23
|
| Rate for Payer: PACE SWMI |
$631.82
|
| Rate for Payer: PHP Commercial |
$2,148.18
|
| Rate for Payer: PHP Medicare Advantage |
$631.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$445.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,198.72
|
| Rate for Payer: Priority Health Medicare |
$638.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,758.98
|
| Rate for Payer: Railroad Medicare Medicare |
$631.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,224.00
|
| Rate for Payer: UHC Core |
$2,110.27
|
| Rate for Payer: UHC Exchange |
$631.82
|
| Rate for Payer: UHC Medicaid |
$445.56
|
| Rate for Payer: UHC Medicare Advantage |
$631.82
|
| Rate for Payer: UHCCP Medicaid |
$445.56
|
| Rate for Payer: VA VA |
$631.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,895.45
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
IP
|
$2,527.27
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,758.98 |
| Max. Negotiated Rate |
$2,274.54 |
| Rate for Payer: Aetna Commercial |
$2,148.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,087.27
|
| Rate for Payer: BCN Commercial |
$2,087.27
|
| Rate for Payer: Cash Price |
$2,021.82
|
| Rate for Payer: Cofinity Commercial |
$2,173.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,021.82
|
| Rate for Payer: Healthscope Commercial |
$2,274.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,895.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,148.18
|
| Rate for Payer: Nomi Health Commercial |
$2,072.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,895.45
|
| Rate for Payer: PHP Commercial |
$2,148.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,198.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,758.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,224.00
|
| Rate for Payer: UHC Core |
$2,110.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,895.45
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$234.90 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: BCBS Trust/PPO |
$278.74
|
| Rate for Payer: BCN Commercial |
$278.74
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: Aetna Medicare |
$87.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.47
|
| Rate for Payer: BCBS Complete |
$62.47
|
| Rate for Payer: BCBS MAPPO |
$84.38
|
| Rate for Payer: BCBS Trust/PPO |
$277.46
|
| Rate for Payer: BCN Commercial |
$277.46
|
| Rate for Payer: BCN Medicare Advantage |
$84.38
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.38
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Mclaren Medicaid |
$59.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.59
|
| Rate for Payer: Meridian Medicaid |
$62.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.12
|
| Rate for Payer: PACE Senior Care Partners |
$80.16
|
| Rate for Payer: PACE SWMI |
$84.38
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: PHP Medicare Advantage |
$84.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Medicare |
$85.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.90
|
| Rate for Payer: Railroad Medicare Medicare |
$84.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: UHC Exchange |
$84.38
|
| Rate for Payer: UHC Medicaid |
$59.50
|
| Rate for Payer: UHC Medicare Advantage |
$84.38
|
| Rate for Payer: UHCCP Medicaid |
$59.50
|
| Rate for Payer: VA VA |
$84.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
OP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$646.03 |
| Max. Negotiated Rate |
$3,297.96 |
| Rate for Payer: Aetna Commercial |
$3,114.74
|
| Rate for Payer: Aetna Medicare |
$952.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,145.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,145.12
|
| Rate for Payer: BCBS Complete |
$678.28
|
| Rate for Payer: BCBS MAPPO |
$916.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,012.50
|
| Rate for Payer: BCN Commercial |
$3,012.50
|
| Rate for Payer: BCN Medicare Advantage |
$916.10
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Commercial |
$3,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.10
|
| Rate for Payer: Healthscope Commercial |
$3,297.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,748.30
|
| Rate for Payer: Mclaren Medicaid |
$646.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$961.90
|
| Rate for Payer: Meridian Medicaid |
$678.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,053.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,007.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Nomi Health Commercial |
$3,004.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: PACE Senior Care Partners |
$870.29
|
| Rate for Payer: PACE SWMI |
$916.10
|
| Rate for Payer: PHP Commercial |
$3,114.74
|
| Rate for Payer: PHP Medicare Advantage |
$916.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$646.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,188.03
|
| Rate for Payer: Priority Health Medicare |
$925.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,550.42
|
| Rate for Payer: Railroad Medicare Medicare |
$916.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,224.67
|
| Rate for Payer: UHC Core |
$3,059.77
|
| Rate for Payer: UHC Exchange |
$916.10
|
| Rate for Payer: UHC Medicaid |
$646.03
|
| Rate for Payer: UHC Medicare Advantage |
$916.10
|
| Rate for Payer: UHCCP Medicaid |
$646.03
|
| Rate for Payer: VA VA |
$916.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,748.30
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
IP
|
$3,664.40
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,550.42 |
| Max. Negotiated Rate |
$3,297.96 |
| Rate for Payer: Aetna Commercial |
$3,114.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,026.43
|
| Rate for Payer: BCN Commercial |
$3,026.43
|
| Rate for Payer: Cash Price |
$2,931.52
|
| Rate for Payer: Cofinity Commercial |
$3,151.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.52
|
| Rate for Payer: Healthscope Commercial |
$3,297.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,748.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,114.74
|
| Rate for Payer: Nomi Health Commercial |
$3,004.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,748.30
|
| Rate for Payer: PHP Commercial |
$3,114.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,188.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,550.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,224.67
|
| Rate for Payer: UHC Core |
$3,059.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,748.30
|
|
