|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
IP
|
$80.11
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.07 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$68.09
|
| Rate for Payer: BCBS Trust/PPO |
$65.39
|
| Rate for Payer: BCN Commercial |
$61.91
|
| Rate for Payer: Cash Price |
$64.09
|
| Rate for Payer: Cofinity Commercial |
$68.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.09
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.09
|
| Rate for Payer: Nomi Health Commercial |
$65.69
|
| Rate for Payer: PHP Commercial |
$68.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.07
|
| Rate for Payer: Priority Health HMO/PPO |
$69.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.50
|
| Rate for Payer: UHC Core |
$66.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.08
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
OP
|
$160.04
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Aetna Commercial |
$136.03
|
| Rate for Payer: Aetna Medicare |
$41.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.01
|
| Rate for Payer: BCBS Complete |
$9.18
|
| Rate for Payer: BCBS MAPPO |
$40.01
|
| Rate for Payer: BCBS Trust/PPO |
$131.57
|
| Rate for Payer: BCN Commercial |
$124.43
|
| Rate for Payer: BCN Medicare Advantage |
$40.01
|
| Rate for Payer: Cash Price |
$128.03
|
| Rate for Payer: Cash Price |
$128.03
|
| Rate for Payer: Cofinity Commercial |
$137.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.01
|
| Rate for Payer: Healthscope Commercial |
$144.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.03
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.01
|
| Rate for Payer: Meridian Medicaid |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.03
|
| Rate for Payer: Nomi Health Commercial |
$131.23
|
| Rate for Payer: PACE Senior Care Partners |
$38.01
|
| Rate for Payer: PACE SWMI |
$40.01
|
| Rate for Payer: PHP Commercial |
$136.03
|
| Rate for Payer: PHP Medicare Advantage |
$40.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.03
|
| Rate for Payer: Priority Health HMO/PPO |
$139.23
|
| Rate for Payer: Priority Health Medicare |
$40.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.23
|
| Rate for Payer: Railroad Medicare Medicare |
$40.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.84
|
| Rate for Payer: UHC Core |
$133.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.01
|
| Rate for Payer: UHC Exchange |
$40.01
|
| Rate for Payer: UHC Medicare Advantage |
$40.01
|
| Rate for Payer: UHCCP Medicaid |
$8.74
|
| Rate for Payer: VA VA |
$40.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.03
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
IP
|
$160.04
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$104.03 |
| Max. Negotiated Rate |
$144.04 |
| Rate for Payer: Aetna Commercial |
$136.03
|
| Rate for Payer: BCBS Trust/PPO |
$130.64
|
| Rate for Payer: BCN Commercial |
$123.68
|
| Rate for Payer: Cash Price |
$128.03
|
| Rate for Payer: Cofinity Commercial |
$137.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.03
|
| Rate for Payer: Healthscope Commercial |
$144.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.03
|
| Rate for Payer: Nomi Health Commercial |
$131.23
|
| Rate for Payer: PHP Commercial |
$136.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.03
|
| Rate for Payer: Priority Health HMO/PPO |
$139.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.84
|
| Rate for Payer: UHC Core |
$133.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.03
|
|
|
HC ENDOPLEGE
|
Facility
|
OP
|
$5,298.73
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,258.45 |
| Max. Negotiated Rate |
$4,768.86 |
| Rate for Payer: Aetna Commercial |
$4,503.92
|
| Rate for Payer: Aetna Medicare |
$1,377.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,655.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,655.85
|
| Rate for Payer: BCBS Complete |
$2,119.49
|
| Rate for Payer: BCBS MAPPO |
$1,324.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,356.09
|
| Rate for Payer: BCN Commercial |
$4,119.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,324.68
|
| Rate for Payer: Cash Price |
$4,238.98
|
| Rate for Payer: Cofinity Commercial |
$4,556.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,238.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,324.68
|
| Rate for Payer: Healthscope Commercial |
$4,768.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,974.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,390.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,523.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,503.92
|
| Rate for Payer: Nomi Health Commercial |
$4,344.96
|
| Rate for Payer: PACE Senior Care Partners |
$1,258.45
|
| Rate for Payer: PACE SWMI |
$1,324.68
|
| Rate for Payer: PHP Commercial |
$4,503.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,324.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,444.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,609.90
|
| Rate for Payer: Priority Health Medicare |
$1,337.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,550.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,324.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,662.88
|
| Rate for Payer: UHC Core |
$4,424.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,324.68
|
| Rate for Payer: UHC Exchange |
$1,324.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.68
|
| Rate for Payer: VA VA |
$1,324.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,974.05
|
|
|
HC ENDOPLEGE
|
Facility
|
IP
|
$5,298.73
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,444.17 |
| Max. Negotiated Rate |
$4,768.86 |
| Rate for Payer: Aetna Commercial |
$4,503.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,325.35
|
| Rate for Payer: BCN Commercial |
$4,094.86
|
| Rate for Payer: Cash Price |
$4,238.98
|
| Rate for Payer: Cofinity Commercial |
$4,556.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,238.98
|
| Rate for Payer: Healthscope Commercial |
$4,768.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,974.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,503.92
|
| Rate for Payer: Nomi Health Commercial |
$4,344.96
|
| Rate for Payer: PHP Commercial |
$4,503.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,444.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,609.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,550.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,662.88
|
| Rate for Payer: UHC Core |
$4,424.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,974.05
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
OP
|
$9,474.00
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,250.08 |
| Max. Negotiated Rate |
$8,526.60 |
| Rate for Payer: Aetna Commercial |
$8,052.90
|
| Rate for Payer: Aetna Medicare |
$2,463.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,960.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,960.62
|
| Rate for Payer: BCBS Complete |
$2,565.51
|
| Rate for Payer: BCBS MAPPO |
$2,368.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,788.58
|
| Rate for Payer: BCN Commercial |
$7,366.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,368.50
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cofinity Commercial |
$8,147.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,579.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,368.50
|
| Rate for Payer: Healthscope Commercial |
$8,526.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,105.50
|
| Rate for Payer: Mclaren Medicaid |
$2,443.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,486.92
|
| Rate for Payer: Meridian Medicaid |
$2,565.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,723.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,052.90
|
| Rate for Payer: Nomi Health Commercial |
$7,768.68
|
| Rate for Payer: PACE Senior Care Partners |
$2,250.08
|
| Rate for Payer: PACE SWMI |
$2,368.50
|
| Rate for Payer: PHP Commercial |
$8,052.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,368.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,443.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,158.10
|
| Rate for Payer: Priority Health HMO/PPO |
$8,242.38
|
| Rate for Payer: Priority Health Medicare |
$2,392.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,347.58
|
| Rate for Payer: Railroad Medicare Medicare |
$2,368.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,337.12
|
| Rate for Payer: UHC Core |
$7,910.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,368.50
|
| Rate for Payer: UHC Exchange |
$2,368.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,368.50
|
| Rate for Payer: UHCCP Medicaid |
$2,443.18
|
| Rate for Payer: VA VA |
$2,368.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,105.50
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
IP
|
$9,474.00
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,158.10 |
| Max. Negotiated Rate |
$8,526.60 |
| Rate for Payer: Aetna Commercial |
$8,052.90
|
| Rate for Payer: BCBS Trust/PPO |
$7,733.63
|
| Rate for Payer: BCN Commercial |
$7,321.51
|
| Rate for Payer: Cash Price |
$7,579.20
|
| Rate for Payer: Cofinity Commercial |
$8,147.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,579.20
|
| Rate for Payer: Healthscope Commercial |
$8,526.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,105.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,052.90
|
| Rate for Payer: Nomi Health Commercial |
$7,768.68
|
| Rate for Payer: PHP Commercial |
$8,052.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,158.10
|
| Rate for Payer: Priority Health HMO/PPO |
$8,242.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,347.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,337.12
|
| Rate for Payer: UHC Core |
$7,910.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,105.50
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.56 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna Medicare |
$128.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.69
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: BCBS MAPPO |
$123.75
|
| Rate for Payer: BCBS Trust/PPO |
$406.94
|
| Rate for Payer: BCN Commercial |
$384.86
|
| Rate for Payer: BCN Medicare Advantage |
$123.75
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.75
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: Nomi Health Commercial |
$405.90
|
| Rate for Payer: PACE Senior Care Partners |
$117.56
|
| Rate for Payer: PACE SWMI |
$123.75
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: PHP Medicare Advantage |
$123.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health HMO/PPO |
$430.65
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.65
|
| Rate for Payer: Railroad Medicare Medicare |
$123.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.60
|
| Rate for Payer: UHC Core |
$413.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.75
|
| Rate for Payer: UHC Exchange |
$123.75
|
| Rate for Payer: UHC Medicare Advantage |
$123.75
|
| Rate for Payer: VA VA |
$123.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$321.75 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: BCBS Trust/PPO |
$404.07
|
| Rate for Payer: BCN Commercial |
$382.54
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: Nomi Health Commercial |
$405.90
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health HMO/PPO |
$430.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.60
|
| Rate for Payer: UHC Core |
$413.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
OP
|
$280.50
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: Aetna Medicare |
$72.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.66
|
| Rate for Payer: BCBS Complete |
$112.20
|
| Rate for Payer: BCBS MAPPO |
$70.12
|
| Rate for Payer: BCBS Trust/PPO |
$230.60
|
| Rate for Payer: BCN Commercial |
$218.09
|
| Rate for Payer: BCN Medicare Advantage |
$70.12
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.12
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.42
|
| Rate for Payer: Nomi Health Commercial |
$230.01
|
| Rate for Payer: PACE Senior Care Partners |
$66.62
|
| Rate for Payer: PACE SWMI |
$70.12
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: PHP Medicare Advantage |
$70.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health HMO/PPO |
$244.04
|
| Rate for Payer: Priority Health Medicare |
$70.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.94
|
| Rate for Payer: Railroad Medicare Medicare |
$70.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.84
|
| Rate for Payer: UHC Core |
$234.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.12
|
| Rate for Payer: UHC Exchange |
$70.12
|
| Rate for Payer: UHC Medicare Advantage |
$70.12
|
| Rate for Payer: VA VA |
$70.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
IP
|
$280.50
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$182.32 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: BCBS Trust/PPO |
$228.97
|
| Rate for Payer: BCN Commercial |
$216.77
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.42
|
| Rate for Payer: Nomi Health Commercial |
$230.01
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health HMO/PPO |
$244.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.84
|
| Rate for Payer: UHC Core |
$234.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$2,771.34
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$658.19 |
| Max. Negotiated Rate |
$2,494.21 |
| Rate for Payer: Aetna Commercial |
$2,355.64
|
| Rate for Payer: Aetna Medicare |
$720.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$866.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$866.04
|
| Rate for Payer: BCBS Complete |
$1,108.54
|
| Rate for Payer: BCBS MAPPO |
$692.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,278.32
|
| Rate for Payer: BCN Commercial |
$2,154.72
|
| Rate for Payer: BCN Medicare Advantage |
$692.84
|
| Rate for Payer: Cash Price |
$2,217.07
|
| Rate for Payer: Cofinity Commercial |
$2,383.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.84
|
| Rate for Payer: Healthscope Commercial |
$2,494.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$727.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,355.64
|
| Rate for Payer: Nomi Health Commercial |
$2,272.50
|
| Rate for Payer: PACE Senior Care Partners |
$658.19
|
| Rate for Payer: PACE SWMI |
$692.84
|
| Rate for Payer: PHP Commercial |
$2,355.64
|
| Rate for Payer: PHP Medicare Advantage |
$692.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$2,411.07
|
| Rate for Payer: Priority Health Medicare |
$699.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,856.80
|
| Rate for Payer: Railroad Medicare Medicare |
$692.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,438.78
|
| Rate for Payer: UHC Core |
$2,314.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$692.84
|
| Rate for Payer: UHC Exchange |
$692.84
|
| Rate for Payer: UHC Medicare Advantage |
$692.84
|
| Rate for Payer: VA VA |
$692.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.50
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$2,771.34
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,801.37 |
| Max. Negotiated Rate |
$2,494.21 |
| Rate for Payer: Aetna Commercial |
$2,355.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,262.24
|
| Rate for Payer: BCN Commercial |
$2,141.69
|
| Rate for Payer: Cash Price |
$2,217.07
|
| Rate for Payer: Cofinity Commercial |
$2,383.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.07
|
| Rate for Payer: Healthscope Commercial |
$2,494.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,078.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,355.64
|
| Rate for Payer: Nomi Health Commercial |
$2,272.50
|
| Rate for Payer: PHP Commercial |
$2,355.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$2,411.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,856.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,438.78
|
| Rate for Payer: UHC Core |
$2,314.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,078.50
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
IP
|
$8,017.20
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,211.18 |
| Max. Negotiated Rate |
$7,215.48 |
| Rate for Payer: Aetna Commercial |
$6,814.62
|
| Rate for Payer: BCBS Trust/PPO |
$6,544.44
|
| Rate for Payer: BCN Commercial |
$6,195.69
|
| Rate for Payer: Cash Price |
$6,413.76
|
| Rate for Payer: Cofinity Commercial |
$6,894.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,413.76
|
| Rate for Payer: Healthscope Commercial |
$7,215.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,012.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,814.62
|
| Rate for Payer: Nomi Health Commercial |
$6,574.10
|
| Rate for Payer: PHP Commercial |
$6,814.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,211.18
|
| Rate for Payer: Priority Health HMO/PPO |
$6,974.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,371.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,055.14
|
| Rate for Payer: UHC Core |
$6,694.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,012.90
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
OP
|
$8,017.20
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,904.08 |
| Max. Negotiated Rate |
$7,215.48 |
| Rate for Payer: Aetna Commercial |
$6,814.62
|
| Rate for Payer: Aetna Medicare |
$2,084.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,505.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,505.38
|
| Rate for Payer: BCBS Complete |
$3,206.88
|
| Rate for Payer: BCBS MAPPO |
$2,004.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,590.94
|
| Rate for Payer: BCN Commercial |
$6,233.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,004.30
|
| Rate for Payer: Cash Price |
$6,413.76
|
| Rate for Payer: Cofinity Commercial |
$6,894.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,413.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,004.30
|
| Rate for Payer: Healthscope Commercial |
$7,215.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,012.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,104.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,304.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,814.62
|
| Rate for Payer: Nomi Health Commercial |
$6,574.10
|
| Rate for Payer: PACE Senior Care Partners |
$1,904.08
|
| Rate for Payer: PACE SWMI |
$2,004.30
|
| Rate for Payer: PHP Commercial |
$6,814.62
|
| Rate for Payer: PHP Medicare Advantage |
$2,004.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,211.18
|
| Rate for Payer: Priority Health HMO/PPO |
$6,974.96
|
| Rate for Payer: Priority Health Medicare |
$2,024.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,371.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,004.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,055.14
|
| Rate for Payer: UHC Core |
$6,694.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,004.30
|
| Rate for Payer: UHC Exchange |
$2,004.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,004.30
|
| Rate for Payer: VA VA |
$2,004.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,012.90
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
OP
|
$8,017.20
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,904.08 |
| Max. Negotiated Rate |
$7,215.48 |
| Rate for Payer: Aetna Commercial |
$6,814.62
|
| Rate for Payer: Aetna Medicare |
$2,084.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,505.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,505.38
|
| Rate for Payer: BCBS Complete |
$3,206.88
|
| Rate for Payer: BCBS MAPPO |
$2,004.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,590.94
|
| Rate for Payer: BCN Commercial |
$6,233.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,004.30
|
| Rate for Payer: Cash Price |
$6,413.76
|
| Rate for Payer: Cofinity Commercial |
$6,894.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,413.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,004.30
|
| Rate for Payer: Healthscope Commercial |
$7,215.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,012.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,104.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,304.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,814.62
|
| Rate for Payer: Nomi Health Commercial |
$6,574.10
|
| Rate for Payer: PACE Senior Care Partners |
$1,904.08
|
| Rate for Payer: PACE SWMI |
$2,004.30
|
| Rate for Payer: PHP Commercial |
$6,814.62
|
| Rate for Payer: PHP Medicare Advantage |
$2,004.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,211.18
|
| Rate for Payer: Priority Health HMO/PPO |
$6,974.96
|
| Rate for Payer: Priority Health Medicare |
$2,024.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,371.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,004.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,055.14
|
| Rate for Payer: UHC Core |
$6,694.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,004.30
|
| Rate for Payer: UHC Exchange |
$2,004.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,004.30
|
| Rate for Payer: VA VA |
$2,004.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,012.90
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
IP
|
$8,017.20
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,211.18 |
| Max. Negotiated Rate |
$7,215.48 |
| Rate for Payer: Aetna Commercial |
$6,814.62
|
| Rate for Payer: BCBS Trust/PPO |
$6,544.44
|
| Rate for Payer: BCN Commercial |
$6,195.69
|
| Rate for Payer: Cash Price |
$6,413.76
|
| Rate for Payer: Cofinity Commercial |
$6,894.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,413.76
|
| Rate for Payer: Healthscope Commercial |
$7,215.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,012.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,814.62
|
| Rate for Payer: Nomi Health Commercial |
$6,574.10
|
| Rate for Payer: PHP Commercial |
$6,814.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,211.18
|
| Rate for Payer: Priority Health HMO/PPO |
$6,974.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,371.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,055.14
|
| Rate for Payer: UHC Core |
$6,694.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,012.90
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
OP
|
$5,102.04
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,211.73 |
| Max. Negotiated Rate |
$4,591.84 |
| Rate for Payer: Aetna Commercial |
$4,336.73
|
| Rate for Payer: Aetna Medicare |
$1,326.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,594.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,594.39
|
| Rate for Payer: BCBS Complete |
$2,040.82
|
| Rate for Payer: BCBS MAPPO |
$1,275.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,194.39
|
| Rate for Payer: BCN Commercial |
$3,966.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.51
|
| Rate for Payer: Cash Price |
$4,081.63
|
| Rate for Payer: Cofinity Commercial |
$4,387.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,081.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.51
|
| Rate for Payer: Healthscope Commercial |
$4,591.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,826.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,466.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,336.73
|
| Rate for Payer: Nomi Health Commercial |
$4,183.67
|
| Rate for Payer: PACE Senior Care Partners |
$1,211.73
|
| Rate for Payer: PACE SWMI |
$1,275.51
|
| Rate for Payer: PHP Commercial |
$4,336.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.33
|
| Rate for Payer: Priority Health HMO/PPO |
$4,438.77
|
| Rate for Payer: Priority Health Medicare |
$1,288.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,418.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,275.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,489.80
|
| Rate for Payer: UHC Core |
$4,260.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.51
|
| Rate for Payer: UHC Exchange |
$1,275.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.51
|
| Rate for Payer: VA VA |
$1,275.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,826.53
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
IP
|
$5,102.04
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,316.33 |
| Max. Negotiated Rate |
$4,591.84 |
| Rate for Payer: Aetna Commercial |
$4,336.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,164.80
|
| Rate for Payer: BCN Commercial |
$3,942.86
|
| Rate for Payer: Cash Price |
$4,081.63
|
| Rate for Payer: Cofinity Commercial |
$4,387.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,081.63
|
| Rate for Payer: Healthscope Commercial |
$4,591.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,826.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,336.73
|
| Rate for Payer: Nomi Health Commercial |
$4,183.67
|
| Rate for Payer: PHP Commercial |
$4,336.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.33
|
| Rate for Payer: Priority Health HMO/PPO |
$4,438.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,418.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,489.80
|
| Rate for Payer: UHC Core |
$4,260.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,826.53
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
IP
|
$788.46
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.50 |
| Max. Negotiated Rate |
$709.61 |
| Rate for Payer: Aetna Commercial |
$670.19
|
| Rate for Payer: BCBS Trust/PPO |
$643.62
|
| Rate for Payer: BCN Commercial |
$609.32
|
| Rate for Payer: Cash Price |
$630.77
|
| Rate for Payer: Cofinity Commercial |
$678.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.77
|
| Rate for Payer: Healthscope Commercial |
$709.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.19
|
| Rate for Payer: Nomi Health Commercial |
$646.54
|
| Rate for Payer: PHP Commercial |
$670.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.50
|
| Rate for Payer: Priority Health HMO/PPO |
$685.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.84
|
| Rate for Payer: UHC Core |
$658.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.34
|
|
|
HC ENDO STENT PLACEMENT
|
Facility
|
OP
|
$788.46
|
|
| Hospital Charge Code |
36000114
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$187.26 |
| Max. Negotiated Rate |
$709.61 |
| Rate for Payer: Aetna Commercial |
$670.19
|
| Rate for Payer: Aetna Medicare |
$205.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.39
|
| Rate for Payer: BCBS Complete |
$315.38
|
| Rate for Payer: BCBS MAPPO |
$197.12
|
| Rate for Payer: BCBS Trust/PPO |
$648.19
|
| Rate for Payer: BCN Commercial |
$613.03
|
| Rate for Payer: BCN Medicare Advantage |
$197.12
|
| Rate for Payer: Cash Price |
$630.77
|
| Rate for Payer: Cofinity Commercial |
$678.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.12
|
| Rate for Payer: Healthscope Commercial |
$709.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.19
|
| Rate for Payer: Nomi Health Commercial |
$646.54
|
| Rate for Payer: PACE Senior Care Partners |
$187.26
|
| Rate for Payer: PACE SWMI |
$197.12
|
| Rate for Payer: PHP Commercial |
$670.19
|
| Rate for Payer: PHP Medicare Advantage |
$197.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.50
|
| Rate for Payer: Priority Health HMO/PPO |
$685.96
|
| Rate for Payer: Priority Health Medicare |
$199.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.27
|
| Rate for Payer: Railroad Medicare Medicare |
$197.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.84
|
| Rate for Payer: UHC Core |
$658.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.12
|
| Rate for Payer: UHC Exchange |
$197.12
|
| Rate for Payer: UHC Medicare Advantage |
$197.12
|
| Rate for Payer: VA VA |
$197.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.34
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
IP
|
$2,996.76
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.89 |
| Max. Negotiated Rate |
$2,697.08 |
| Rate for Payer: Aetna Commercial |
$2,547.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,446.26
|
| Rate for Payer: BCN Commercial |
$2,315.90
|
| Rate for Payer: Cash Price |
$2,397.41
|
| Rate for Payer: Cofinity Commercial |
$2,577.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,397.41
|
| Rate for Payer: Healthscope Commercial |
$2,697.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,547.25
|
| Rate for Payer: Nomi Health Commercial |
$2,457.34
|
| Rate for Payer: PHP Commercial |
$2,547.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.89
|
| Rate for Payer: Priority Health HMO/PPO |
$2,607.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,637.15
|
| Rate for Payer: UHC Core |
$2,502.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.57
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
OP
|
$2,996.76
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$711.73 |
| Max. Negotiated Rate |
$2,697.08 |
| Rate for Payer: Aetna Commercial |
$2,547.25
|
| Rate for Payer: Aetna Medicare |
$779.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$936.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$936.49
|
| Rate for Payer: BCBS Complete |
$1,198.70
|
| Rate for Payer: BCBS MAPPO |
$749.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,463.64
|
| Rate for Payer: BCN Commercial |
$2,329.98
|
| Rate for Payer: BCN Medicare Advantage |
$749.19
|
| Rate for Payer: Cash Price |
$2,397.41
|
| Rate for Payer: Cofinity Commercial |
$2,577.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,397.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.19
|
| Rate for Payer: Healthscope Commercial |
$2,697.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$861.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,547.25
|
| Rate for Payer: Nomi Health Commercial |
$2,457.34
|
| Rate for Payer: PACE Senior Care Partners |
$711.73
|
| Rate for Payer: PACE SWMI |
$749.19
|
| Rate for Payer: PHP Commercial |
$2,547.25
|
| Rate for Payer: PHP Medicare Advantage |
$749.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.89
|
| Rate for Payer: Priority Health HMO/PPO |
$2,607.18
|
| Rate for Payer: Priority Health Medicare |
$756.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.83
|
| Rate for Payer: Railroad Medicare Medicare |
$749.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,637.15
|
| Rate for Payer: UHC Core |
$2,502.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$749.19
|
| Rate for Payer: UHC Exchange |
$749.19
|
| Rate for Payer: UHC Medicare Advantage |
$749.19
|
| Rate for Payer: VA VA |
$749.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.57
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
OP
|
$4,078.88
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$968.73 |
| Max. Negotiated Rate |
$3,670.99 |
| Rate for Payer: Aetna Commercial |
$3,467.05
|
| Rate for Payer: Aetna Medicare |
$1,060.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,274.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,274.65
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,019.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,353.25
|
| Rate for Payer: BCN Commercial |
$3,171.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,019.72
|
| Rate for Payer: Cash Price |
$3,263.10
|
| Rate for Payer: Cash Price |
$3,263.10
|
| Rate for Payer: Cofinity Commercial |
$3,507.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,263.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,019.72
|
| Rate for Payer: Healthscope Commercial |
$3,670.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,059.16
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.71
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,172.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,467.05
|
| Rate for Payer: Nomi Health Commercial |
$3,344.68
|
| Rate for Payer: PACE Senior Care Partners |
$968.73
|
| Rate for Payer: PACE SWMI |
$1,019.72
|
| Rate for Payer: PHP Commercial |
$3,467.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,019.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,651.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,548.63
|
| Rate for Payer: Priority Health Medicare |
$1,029.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,019.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,589.41
|
| Rate for Payer: UHC Core |
$3,405.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,019.72
|
| Rate for Payer: UHC Exchange |
$1,019.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,019.72
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,019.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,059.16
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
IP
|
$4,078.88
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,651.27 |
| Max. Negotiated Rate |
$3,670.99 |
| Rate for Payer: Aetna Commercial |
$3,467.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,329.59
|
| Rate for Payer: BCN Commercial |
$3,152.16
|
| Rate for Payer: Cash Price |
$3,263.10
|
| Rate for Payer: Cofinity Commercial |
$3,507.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,263.10
|
| Rate for Payer: Healthscope Commercial |
$3,670.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,059.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,467.05
|
| Rate for Payer: Nomi Health Commercial |
$3,344.68
|
| Rate for Payer: PHP Commercial |
$3,467.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,651.27
|
| Rate for Payer: Priority Health HMO/PPO |
$3,548.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,589.41
|
| Rate for Payer: UHC Core |
$3,405.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,059.16
|
|
