|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
OP
|
$840.56
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$199.63 |
| Max. Negotiated Rate |
$756.50 |
| Rate for Payer: Aetna Commercial |
$714.48
|
| Rate for Payer: Aetna Medicare |
$218.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.68
|
| Rate for Payer: BCBS Complete |
$336.22
|
| Rate for Payer: BCBS MAPPO |
$210.14
|
| Rate for Payer: BCBS Trust/PPO |
$691.02
|
| Rate for Payer: BCN Commercial |
$653.54
|
| Rate for Payer: BCN Medicare Advantage |
$210.14
|
| Rate for Payer: Cash Price |
$672.45
|
| Rate for Payer: Cofinity Commercial |
$722.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$672.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.14
|
| Rate for Payer: Healthscope Commercial |
$756.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$630.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$714.48
|
| Rate for Payer: Nomi Health Commercial |
$689.26
|
| Rate for Payer: PACE Senior Care Partners |
$199.63
|
| Rate for Payer: PACE SWMI |
$210.14
|
| Rate for Payer: PHP Commercial |
$714.48
|
| Rate for Payer: PHP Medicare Advantage |
$210.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.36
|
| Rate for Payer: Priority Health HMO/PPO |
$731.29
|
| Rate for Payer: Priority Health Medicare |
$212.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.18
|
| Rate for Payer: Railroad Medicare Medicare |
$210.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$739.69
|
| Rate for Payer: UHC Core |
$701.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.14
|
| Rate for Payer: UHC Exchange |
$210.14
|
| Rate for Payer: UHC Medicare Advantage |
$210.14
|
| Rate for Payer: VA VA |
$210.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$630.42
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
OP
|
$2,676.43
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$635.65 |
| Max. Negotiated Rate |
$2,408.79 |
| Rate for Payer: Aetna Commercial |
$2,274.97
|
| Rate for Payer: Aetna Medicare |
$695.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$836.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$836.38
|
| Rate for Payer: BCBS Complete |
$1,070.57
|
| Rate for Payer: BCBS MAPPO |
$669.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,200.29
|
| Rate for Payer: BCN Commercial |
$2,080.92
|
| Rate for Payer: BCN Medicare Advantage |
$669.11
|
| Rate for Payer: Cash Price |
$2,141.14
|
| Rate for Payer: Cofinity Commercial |
$2,301.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,141.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.11
|
| Rate for Payer: Healthscope Commercial |
$2,408.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,007.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$702.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$769.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,274.97
|
| Rate for Payer: Nomi Health Commercial |
$2,194.67
|
| Rate for Payer: PACE Senior Care Partners |
$635.65
|
| Rate for Payer: PACE SWMI |
$669.11
|
| Rate for Payer: PHP Commercial |
$2,274.97
|
| Rate for Payer: PHP Medicare Advantage |
$669.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,739.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,328.49
|
| Rate for Payer: Priority Health Medicare |
$675.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,793.21
|
| Rate for Payer: Railroad Medicare Medicare |
$669.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,355.26
|
| Rate for Payer: UHC Core |
$2,234.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$669.11
|
| Rate for Payer: UHC Exchange |
$669.11
|
| Rate for Payer: UHC Medicare Advantage |
$669.11
|
| Rate for Payer: VA VA |
$669.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,007.32
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
IP
|
$2,676.43
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,739.68 |
| Max. Negotiated Rate |
$2,408.79 |
| Rate for Payer: Aetna Commercial |
$2,274.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,184.77
|
| Rate for Payer: BCN Commercial |
$2,068.35
|
| Rate for Payer: Cash Price |
$2,141.14
|
| Rate for Payer: Cofinity Commercial |
$2,301.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,141.14
|
| Rate for Payer: Healthscope Commercial |
$2,408.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,007.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,274.97
|
| Rate for Payer: Nomi Health Commercial |
$2,194.67
|
| Rate for Payer: PHP Commercial |
$2,274.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,739.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,328.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,793.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,355.26
|
| Rate for Payer: UHC Core |
$2,234.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,007.32
|
|
|
HC FIBRINOGEN
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC FIBRINOGEN
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
IP
|
$290.70
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$188.96 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.10
|
| Rate for Payer: BCBS Trust/PPO |
$237.30
|
| Rate for Payer: BCN Commercial |
$224.65
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.10
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: PHP Commercial |
$247.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.02
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.10
|
| Rate for Payer: Aetna Medicare |
$75.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.84
|
| Rate for Payer: BCBS Complete |
$54.81
|
| Rate for Payer: BCBS MAPPO |
$72.68
|
| Rate for Payer: BCBS Trust/PPO |
$238.98
|
| Rate for Payer: BCN Commercial |
$226.02
|
| Rate for Payer: BCN Medicare Advantage |
$72.68
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.68
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.02
|
| Rate for Payer: Mclaren Medicaid |
$52.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.31
|
| Rate for Payer: Meridian Medicaid |
$54.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.10
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: PACE Senior Care Partners |
$69.04
|
| Rate for Payer: PACE SWMI |
$72.68
|
| Rate for Payer: PHP Commercial |
$247.10
|
| Rate for Payer: PHP Medicare Advantage |
$72.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Medicare |
$73.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.77
|
| Rate for Payer: Railroad Medicare Medicare |
$72.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.68
|
| Rate for Payer: UHC Exchange |
$72.68
|
| Rate for Payer: UHC Medicare Advantage |
$72.68
|
| Rate for Payer: UHCCP Medicaid |
$52.19
|
| Rate for Payer: VA VA |
$72.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.02
|
|
|
HC FILSHIE CLIP
|
Facility
|
OP
|
$335.82
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.76 |
| Max. Negotiated Rate |
$302.24 |
| Rate for Payer: Aetna Commercial |
$285.45
|
| Rate for Payer: Aetna Medicare |
$87.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.94
|
| Rate for Payer: BCBS Complete |
$134.33
|
| Rate for Payer: BCBS MAPPO |
$83.96
|
| Rate for Payer: BCBS Trust/PPO |
$276.08
|
| Rate for Payer: BCN Commercial |
$261.10
|
| Rate for Payer: BCN Medicare Advantage |
$83.96
|
| Rate for Payer: Cash Price |
$268.66
|
| Rate for Payer: Cofinity Commercial |
$288.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.96
|
| Rate for Payer: Healthscope Commercial |
$302.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.45
|
| Rate for Payer: Nomi Health Commercial |
$275.37
|
| Rate for Payer: PACE Senior Care Partners |
$79.76
|
| Rate for Payer: PACE SWMI |
$83.96
|
| Rate for Payer: PHP Commercial |
$285.45
|
| Rate for Payer: PHP Medicare Advantage |
$83.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.28
|
| Rate for Payer: Priority Health HMO/PPO |
$292.16
|
| Rate for Payer: Priority Health Medicare |
$84.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.00
|
| Rate for Payer: Railroad Medicare Medicare |
$83.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.52
|
| Rate for Payer: UHC Core |
$280.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.96
|
| Rate for Payer: UHC Exchange |
$83.96
|
| Rate for Payer: UHC Medicare Advantage |
$83.96
|
| Rate for Payer: VA VA |
$83.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.86
|
|
|
HC FILSHIE CLIP
|
Facility
|
IP
|
$335.82
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$218.28 |
| Max. Negotiated Rate |
$302.24 |
| Rate for Payer: Aetna Commercial |
$285.45
|
| Rate for Payer: BCBS Trust/PPO |
$274.13
|
| Rate for Payer: BCN Commercial |
$259.52
|
| Rate for Payer: Cash Price |
$268.66
|
| Rate for Payer: Cofinity Commercial |
$288.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.66
|
| Rate for Payer: Healthscope Commercial |
$302.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.45
|
| Rate for Payer: Nomi Health Commercial |
$275.37
|
| Rate for Payer: PHP Commercial |
$285.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.28
|
| Rate for Payer: Priority Health HMO/PPO |
$292.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.52
|
| Rate for Payer: UHC Core |
$280.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.86
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
IP
|
$58.14
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
OP
|
$58.14
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.81 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$23.26
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC FILTERWIRE
|
Facility
|
OP
|
$3,814.45
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$905.93 |
| Max. Negotiated Rate |
$3,433.00 |
| Rate for Payer: Aetna Commercial |
$3,242.28
|
| Rate for Payer: Aetna Medicare |
$991.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,192.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,192.02
|
| Rate for Payer: BCBS Complete |
$1,525.78
|
| Rate for Payer: BCBS MAPPO |
$953.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,135.86
|
| Rate for Payer: BCN Commercial |
$2,965.73
|
| Rate for Payer: BCN Medicare Advantage |
$953.61
|
| Rate for Payer: Cash Price |
$3,051.56
|
| Rate for Payer: Cofinity Commercial |
$3,280.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.61
|
| Rate for Payer: Healthscope Commercial |
$3,433.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,860.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,096.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,242.28
|
| Rate for Payer: Nomi Health Commercial |
$3,127.85
|
| Rate for Payer: PACE Senior Care Partners |
$905.93
|
| Rate for Payer: PACE SWMI |
$953.61
|
| Rate for Payer: PHP Commercial |
$3,242.28
|
| Rate for Payer: PHP Medicare Advantage |
$953.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,479.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,318.57
|
| Rate for Payer: Priority Health Medicare |
$963.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,555.68
|
| Rate for Payer: Railroad Medicare Medicare |
$953.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,356.72
|
| Rate for Payer: UHC Core |
$3,185.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.61
|
| Rate for Payer: UHC Exchange |
$953.61
|
| Rate for Payer: UHC Medicare Advantage |
$953.61
|
| Rate for Payer: VA VA |
$953.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,860.84
|
|
|
HC FILTERWIRE
|
Facility
|
IP
|
$3,814.45
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,479.39 |
| Max. Negotiated Rate |
$3,433.00 |
| Rate for Payer: Aetna Commercial |
$3,242.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,113.74
|
| Rate for Payer: BCN Commercial |
$2,947.81
|
| Rate for Payer: Cash Price |
$3,051.56
|
| Rate for Payer: Cofinity Commercial |
$3,280.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.56
|
| Rate for Payer: Healthscope Commercial |
$3,433.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,860.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,242.28
|
| Rate for Payer: Nomi Health Commercial |
$3,127.85
|
| Rate for Payer: PHP Commercial |
$3,242.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,479.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,318.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,555.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,356.72
|
| Rate for Payer: UHC Core |
$3,185.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,860.84
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
OP
|
$20.81
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
IP
|
$20.81
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
OP
|
$168.54
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.67
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$42.14
|
| Rate for Payer: BCBS Trust/PPO |
$138.56
|
| Rate for Payer: BCN Commercial |
$131.04
|
| Rate for Payer: BCN Medicare Advantage |
$42.14
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.14
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.40
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: PACE Senior Care Partners |
$40.03
|
| Rate for Payer: PACE SWMI |
$42.14
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: PHP Medicare Advantage |
$42.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.55
|
| Rate for Payer: Priority Health HMO/PPO |
$146.63
|
| Rate for Payer: Priority Health Medicare |
$42.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.92
|
| Rate for Payer: Railroad Medicare Medicare |
$42.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.32
|
| Rate for Payer: UHC Core |
$140.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.14
|
| Rate for Payer: UHC Exchange |
$42.14
|
| Rate for Payer: UHC Medicare Advantage |
$42.14
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$42.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.40
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
IP
|
$168.54
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.55 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: BCBS Trust/PPO |
$137.58
|
| Rate for Payer: BCN Commercial |
$130.25
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.55
|
| Rate for Payer: Priority Health HMO/PPO |
$146.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.32
|
| Rate for Payer: UHC Core |
$140.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.40
|
|
|
HC FISH PROBES
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.57
|
| Rate for Payer: BCN Commercial |
$60.18
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC FISH PROBES
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$20.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.33
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$64.02
|
| Rate for Payer: BCN Commercial |
$60.54
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PACE Senior Care Partners |
$18.49
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Medicare |
$19.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: Railroad Medicare Medicare |
$19.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.47
|
| Rate for Payer: UHC Exchange |
$19.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$19.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
IP
|
$2,254.14
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,465.19 |
| Max. Negotiated Rate |
$2,028.73 |
| Rate for Payer: Aetna Commercial |
$1,916.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.05
|
| Rate for Payer: BCN Commercial |
$1,742.00
|
| Rate for Payer: Cash Price |
$1,803.31
|
| Rate for Payer: Cofinity Commercial |
$1,938.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.31
|
| Rate for Payer: Healthscope Commercial |
$2,028.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,916.02
|
| Rate for Payer: Nomi Health Commercial |
$1,848.39
|
| Rate for Payer: PHP Commercial |
$1,916.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,961.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,510.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,983.64
|
| Rate for Payer: UHC Core |
$1,882.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.60
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
OP
|
$2,254.14
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$535.36 |
| Max. Negotiated Rate |
$2,028.73 |
| Rate for Payer: Aetna Commercial |
$1,916.02
|
| Rate for Payer: Aetna Medicare |
$586.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$704.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$704.42
|
| Rate for Payer: BCBS Complete |
$901.66
|
| Rate for Payer: BCBS MAPPO |
$563.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,853.13
|
| Rate for Payer: BCN Commercial |
$1,752.59
|
| Rate for Payer: BCN Medicare Advantage |
$563.54
|
| Rate for Payer: Cash Price |
$1,803.31
|
| Rate for Payer: Cofinity Commercial |
$1,938.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$2,028.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,916.02
|
| Rate for Payer: Nomi Health Commercial |
$1,848.39
|
| Rate for Payer: PACE Senior Care Partners |
$535.36
|
| Rate for Payer: PACE SWMI |
$563.54
|
| Rate for Payer: PHP Commercial |
$1,916.02
|
| Rate for Payer: PHP Medicare Advantage |
$563.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,961.10
|
| Rate for Payer: Priority Health Medicare |
$569.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,510.27
|
| Rate for Payer: Railroad Medicare Medicare |
$563.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,983.64
|
| Rate for Payer: UHC Core |
$1,882.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.54
|
| Rate for Payer: UHC Exchange |
$563.54
|
| Rate for Payer: UHC Medicare Advantage |
$563.54
|
| Rate for Payer: VA VA |
$563.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.60
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
OP
|
$258.96
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$233.06 |
| Rate for Payer: Aetna Commercial |
$220.12
|
| Rate for Payer: Aetna Medicare |
$67.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.92
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$64.74
|
| Rate for Payer: BCBS Trust/PPO |
$212.89
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: BCN Medicare Advantage |
$64.74
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.74
|
| Rate for Payer: Healthscope Commercial |
$233.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.22
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.98
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.12
|
| Rate for Payer: Nomi Health Commercial |
$212.35
|
| Rate for Payer: PACE Senior Care Partners |
$61.50
|
| Rate for Payer: PACE SWMI |
$64.74
|
| Rate for Payer: PHP Commercial |
$220.12
|
| Rate for Payer: PHP Medicare Advantage |
$64.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.32
|
| Rate for Payer: Priority Health HMO/PPO |
$225.30
|
| Rate for Payer: Priority Health Medicare |
$65.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.50
|
| Rate for Payer: Railroad Medicare Medicare |
$64.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.88
|
| Rate for Payer: UHC Core |
$216.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.74
|
| Rate for Payer: UHC Exchange |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$64.74
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$64.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.22
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
IP
|
$258.96
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.32 |
| Max. Negotiated Rate |
$233.06 |
| Rate for Payer: Aetna Commercial |
$220.12
|
| Rate for Payer: BCBS Trust/PPO |
$211.39
|
| Rate for Payer: BCN Commercial |
$200.12
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.17
|
| Rate for Payer: Healthscope Commercial |
$233.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.12
|
| Rate for Payer: Nomi Health Commercial |
$212.35
|
| Rate for Payer: PHP Commercial |
$220.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.32
|
| Rate for Payer: Priority Health HMO/PPO |
$225.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.88
|
| Rate for Payer: UHC Core |
$216.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.22
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
OP
|
$524.95
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$472.46 |
| Rate for Payer: Aetna Commercial |
$446.21
|
| Rate for Payer: Aetna Medicare |
$136.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.05
|
| Rate for Payer: BCBS Complete |
$149.64
|
| Rate for Payer: BCBS MAPPO |
$131.24
|
| Rate for Payer: BCBS Trust/PPO |
$431.56
|
| Rate for Payer: BCN Commercial |
$408.15
|
| Rate for Payer: BCN Medicare Advantage |
$131.24
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cofinity Commercial |
$451.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.24
|
| Rate for Payer: Healthscope Commercial |
$472.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.71
|
| Rate for Payer: Mclaren Medicaid |
$142.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.80
|
| Rate for Payer: Meridian Medicaid |
$149.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.21
|
| Rate for Payer: Nomi Health Commercial |
$430.46
|
| Rate for Payer: PACE Senior Care Partners |
$124.68
|
| Rate for Payer: PACE SWMI |
$131.24
|
| Rate for Payer: PHP Commercial |
$446.21
|
| Rate for Payer: PHP Medicare Advantage |
$131.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.22
|
| Rate for Payer: Priority Health HMO/PPO |
$456.71
|
| Rate for Payer: Priority Health Medicare |
$132.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.72
|
| Rate for Payer: Railroad Medicare Medicare |
$131.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.96
|
| Rate for Payer: UHC Core |
$438.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.24
|
| Rate for Payer: UHC Exchange |
$131.24
|
| Rate for Payer: UHC Medicare Advantage |
$131.24
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: VA VA |
$131.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.71
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
IP
|
$524.95
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.22 |
| Max. Negotiated Rate |
$472.46 |
| Rate for Payer: Aetna Commercial |
$446.21
|
| Rate for Payer: BCBS Trust/PPO |
$428.52
|
| Rate for Payer: BCN Commercial |
$405.68
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cofinity Commercial |
$451.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.96
|
| Rate for Payer: Healthscope Commercial |
$472.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.21
|
| Rate for Payer: Nomi Health Commercial |
$430.46
|
| Rate for Payer: PHP Commercial |
$446.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.22
|
| Rate for Payer: Priority Health HMO/PPO |
$456.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.96
|
| Rate for Payer: UHC Core |
$438.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.71
|
|
