|
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 |
$238.43
|
| 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 |
$238.43
|
| Rate for Payer: Nomi Health Commercial |
$230.01
|
| Rate for Payer: PHP Commercial |
$238.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health HMO/PPO |
$244.03
|
| 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 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 |
$238.43
|
| 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 |
$238.43
|
| 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 |
$238.43
|
| 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 |
$244.03
|
| 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 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 |
$2,078.51
|
| 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 |
$2,078.51
|
|
|
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 |
$2,078.51
|
| 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 |
$2,078.51
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
OP
|
$8,017.20
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,904.09 |
| 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 |
$2,104.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,304.95
|
| 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 |
$1,904.09
|
| 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 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 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 MUCOSAL RESECTION HOT
|
Facility
|
OP
|
$8,017.20
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,904.09 |
| 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 |
$2,104.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,304.95
|
| 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 |
$1,904.09
|
| 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 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 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 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 |
$591.35
|
| 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 |
$591.35
|
|
|
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 |
$591.35
|
| 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 |
$591.35
|
|
|
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 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 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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.71
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| 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
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
OP
|
$261.53
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$235.38 |
| Rate for Payer: Aetna Commercial |
$222.30
|
| Rate for Payer: Aetna Medicare |
$68.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.73
|
| Rate for Payer: BCBS Complete |
$104.61
|
| Rate for Payer: BCBS MAPPO |
$65.38
|
| Rate for Payer: BCBS Trust/PPO |
$215.00
|
| Rate for Payer: BCN Commercial |
$203.34
|
| Rate for Payer: BCN Medicare Advantage |
$65.38
|
| Rate for Payer: Cash Price |
$209.22
|
| Rate for Payer: Cofinity Commercial |
$224.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.38
|
| Rate for Payer: Healthscope Commercial |
$235.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.30
|
| Rate for Payer: Nomi Health Commercial |
$214.45
|
| Rate for Payer: PACE Senior Care Partners |
$62.11
|
| Rate for Payer: PACE SWMI |
$65.38
|
| Rate for Payer: PHP Commercial |
$222.30
|
| Rate for Payer: PHP Medicare Advantage |
$65.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.99
|
| Rate for Payer: Priority Health HMO/PPO |
$227.53
|
| Rate for Payer: Priority Health Medicare |
$66.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.23
|
| Rate for Payer: Railroad Medicare Medicare |
$65.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.15
|
| Rate for Payer: UHC Core |
$218.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.38
|
| Rate for Payer: UHC Exchange |
$65.38
|
| Rate for Payer: UHC Medicare Advantage |
$65.38
|
| Rate for Payer: VA VA |
$65.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.15
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
IP
|
$261.53
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$169.99 |
| Max. Negotiated Rate |
$235.38 |
| Rate for Payer: Aetna Commercial |
$222.30
|
| Rate for Payer: BCBS Trust/PPO |
$213.49
|
| Rate for Payer: BCN Commercial |
$202.11
|
| Rate for Payer: Cash Price |
$209.22
|
| Rate for Payer: Cofinity Commercial |
$224.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.22
|
| Rate for Payer: Healthscope Commercial |
$235.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.30
|
| Rate for Payer: Nomi Health Commercial |
$214.45
|
| Rate for Payer: PHP Commercial |
$222.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.99
|
| Rate for Payer: Priority Health HMO/PPO |
$227.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.15
|
| Rate for Payer: UHC Core |
$218.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.15
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
OP
|
$4,122.36
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$979.06 |
| Max. Negotiated Rate |
$3,710.12 |
| Rate for Payer: Aetna Commercial |
$3,504.01
|
| Rate for Payer: Aetna Medicare |
$1,071.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,288.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,288.24
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$1,030.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,388.99
|
| Rate for Payer: BCN Commercial |
$3,205.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,030.59
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cofinity Commercial |
$3,545.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,297.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,030.59
|
| Rate for Payer: Healthscope Commercial |
$3,710.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,091.77
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,082.12
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,185.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,504.01
|
| Rate for Payer: Nomi Health Commercial |
$3,380.34
|
| Rate for Payer: PACE Senior Care Partners |
$979.06
|
| Rate for Payer: PACE SWMI |
$1,030.59
|
| Rate for Payer: PHP Commercial |
$3,504.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,030.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,679.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,586.45
|
| Rate for Payer: Priority Health Medicare |
$1,040.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,761.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,030.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,627.68
|
| Rate for Payer: UHC Core |
$3,442.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,030.59
|
| Rate for Payer: UHC Exchange |
$1,030.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,030.59
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$1,030.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,091.77
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
IP
|
$4,122.36
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,679.53 |
| Max. Negotiated Rate |
$3,710.12 |
| Rate for Payer: Aetna Commercial |
$3,504.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,365.08
|
| Rate for Payer: BCN Commercial |
$3,185.76
|
| Rate for Payer: Cash Price |
$3,297.89
|
| Rate for Payer: Cofinity Commercial |
$3,545.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,297.89
|
| Rate for Payer: Healthscope Commercial |
$3,710.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,091.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,504.01
|
| Rate for Payer: Nomi Health Commercial |
$3,380.34
|
| Rate for Payer: PHP Commercial |
$3,504.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,679.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,586.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,761.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,627.68
|
| Rate for Payer: UHC Core |
$3,442.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,091.77
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,141.32 |
| Max. Negotiated Rate |
$4,324.99 |
| Rate for Payer: Aetna Commercial |
$4,084.71
|
| Rate for Payer: Aetna Medicare |
$1,249.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,501.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,501.73
|
| Rate for Payer: BCBS Complete |
$1,922.22
|
| Rate for Payer: BCBS MAPPO |
$1,201.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,950.63
|
| Rate for Payer: BCN Commercial |
$3,736.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.38
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$4,132.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.38
|
| Rate for Payer: Healthscope Commercial |
$4,324.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,604.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,261.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,381.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: Nomi Health Commercial |
$3,940.54
|
| Rate for Payer: PACE Senior Care Partners |
$1,141.32
|
| Rate for Payer: PACE SWMI |
$1,201.38
|
| Rate for Payer: PHP Commercial |
$4,084.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: Priority Health HMO/PPO |
$4,180.82
|
| Rate for Payer: Priority Health Medicare |
$1,213.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,219.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,201.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,228.88
|
| Rate for Payer: UHC Core |
$4,012.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,201.38
|
| Rate for Payer: UHC Exchange |
$1,201.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,201.38
|
| Rate for Payer: VA VA |
$1,201.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,604.16
|
|
|
HC ENDOVENT
|
Facility
|
IP
|
$4,805.54
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,123.60 |
| Max. Negotiated Rate |
$4,324.99 |
| Rate for Payer: Aetna Commercial |
$4,084.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,922.76
|
| Rate for Payer: BCN Commercial |
$3,713.72
|
| Rate for Payer: Cash Price |
$3,844.43
|
| Rate for Payer: Cofinity Commercial |
$4,132.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,844.43
|
| Rate for Payer: Healthscope Commercial |
$4,324.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,604.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,084.71
|
| Rate for Payer: Nomi Health Commercial |
$3,940.54
|
| Rate for Payer: PHP Commercial |
$4,084.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,123.60
|
| Rate for Payer: Priority Health HMO/PPO |
$4,180.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,219.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,228.88
|
| Rate for Payer: UHC Core |
$4,012.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,604.16
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,801.14
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,120.74 |
| Max. Negotiated Rate |
$4,321.03 |
| Rate for Payer: Aetna Commercial |
$4,080.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,919.17
|
| Rate for Payer: BCN Commercial |
$3,710.32
|
| Rate for Payer: Cash Price |
$3,840.91
|
| Rate for Payer: Cofinity Commercial |
$4,128.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,840.91
|
| Rate for Payer: Healthscope Commercial |
$4,321.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,600.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,080.97
|
| Rate for Payer: Nomi Health Commercial |
$3,936.93
|
| Rate for Payer: PHP Commercial |
$4,080.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,120.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,176.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,216.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,225.00
|
| Rate for Payer: UHC Core |
$4,008.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,600.86
|
|
