|
HC GROUP PSYCHOTHERAPY
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$80.68
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
IP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$41.01 |
| Max. Negotiated Rate |
$56.78 |
| Rate for Payer: Aetna Commercial |
$53.63
|
| Rate for Payer: BCBS Trust/PPO |
$51.50
|
| Rate for Payer: BCN Commercial |
$48.76
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: PHP Commercial |
$53.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: Priority Health HMO/PPO |
$54.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.52
|
| Rate for Payer: UHC Core |
$52.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.32
|
|
|
HC GROUP SESSION 30 MIN RD G0109
|
Facility
|
OP
|
$63.09
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200028
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$56.78 |
| Rate for Payer: Aetna Commercial |
$53.63
|
| Rate for Payer: Aetna Medicare |
$16.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.72
|
| Rate for Payer: BCBS Complete |
$25.24
|
| Rate for Payer: BCBS MAPPO |
$15.77
|
| Rate for Payer: BCBS Trust/PPO |
$51.87
|
| Rate for Payer: BCN Commercial |
$49.05
|
| Rate for Payer: BCN Medicare Advantage |
$15.77
|
| Rate for Payer: Cash Price |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$54.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.77
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.63
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: PACE Senior Care Partners |
$14.98
|
| Rate for Payer: PACE SWMI |
$15.77
|
| Rate for Payer: PHP Commercial |
$53.63
|
| Rate for Payer: PHP Medicare Advantage |
$15.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.01
|
| Rate for Payer: Priority Health HMO/PPO |
$54.89
|
| Rate for Payer: Priority Health Medicare |
$15.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.27
|
| Rate for Payer: Railroad Medicare Medicare |
$15.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.52
|
| Rate for Payer: UHC Core |
$52.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.77
|
| Rate for Payer: UHC Exchange |
$15.77
|
| Rate for Payer: UHC Medicare Advantage |
$15.77
|
| Rate for Payer: VA VA |
$15.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.32
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
OP
|
$107.21
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$96.49 |
| Rate for Payer: Aetna Commercial |
$91.13
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.50
|
| Rate for Payer: BCBS Complete |
$42.88
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.14
|
| Rate for Payer: BCN Commercial |
$83.36
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: Cash Price |
$85.77
|
| Rate for Payer: Cofinity Commercial |
$92.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$96.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.13
|
| Rate for Payer: Nomi Health Commercial |
$87.91
|
| Rate for Payer: PACE Senior Care Partners |
$25.46
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PHP Commercial |
$91.13
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.69
|
| Rate for Payer: Priority Health HMO/PPO |
$93.27
|
| Rate for Payer: Priority Health Medicare |
$27.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.83
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.34
|
| Rate for Payer: UHC Core |
$89.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.80
|
| Rate for Payer: UHC Exchange |
$26.80
|
| Rate for Payer: UHC Medicare Advantage |
$26.80
|
| Rate for Payer: VA VA |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.41
|
|
|
HC GROUP THERAPEUTIC PROCEDURES
|
Facility
|
IP
|
$107.21
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
42000027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$69.69 |
| Max. Negotiated Rate |
$96.49 |
| Rate for Payer: Aetna Commercial |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$87.52
|
| Rate for Payer: BCN Commercial |
$82.85
|
| Rate for Payer: Cash Price |
$85.77
|
| Rate for Payer: Cofinity Commercial |
$92.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.77
|
| Rate for Payer: Healthscope Commercial |
$96.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.13
|
| Rate for Payer: Nomi Health Commercial |
$87.91
|
| Rate for Payer: PHP Commercial |
$91.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.69
|
| Rate for Payer: Priority Health HMO/PPO |
$93.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.34
|
| Rate for Payer: UHC Core |
$89.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.41
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$12.66
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: Meridian Medicaid |
$12.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Exchange |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$16.58
|
| Rate for Payer: UHCCP Medicaid |
$12.05
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC GROWTH HORMONE HGH
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
30100752
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: BCBS Trust/PPO |
$552.03
|
| Rate for Payer: BCN Commercial |
$522.61
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.20
|
|
|
HC GROWTH HORMONE STIMULATION TEST
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 96365
|
| Hospital Charge Code |
76100362
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$149.25 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna Medicare |
$175.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.33
|
| Rate for Payer: BCBS Complete |
$156.72
|
| Rate for Payer: BCBS MAPPO |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$555.95
|
| Rate for Payer: BCN Commercial |
$525.79
|
| Rate for Payer: BCN Medicare Advantage |
$169.06
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.06
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.20
|
| Rate for Payer: Mclaren Medicaid |
$149.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.52
|
| Rate for Payer: Meridian Medicaid |
$156.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Senior Care Partners |
$160.61
|
| Rate for Payer: PACE SWMI |
$169.06
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: PHP Medicare Advantage |
$169.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Medicare |
$170.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.09
|
| Rate for Payer: Railroad Medicare Medicare |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.06
|
| Rate for Payer: UHC Exchange |
$169.06
|
| Rate for Payer: UHC Medicare Advantage |
$169.06
|
| Rate for Payer: UHCCP Medicaid |
$149.25
|
| Rate for Payer: VA VA |
$169.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.20
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC GSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200011
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
IP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$374.72 |
| Max. Negotiated Rate |
$518.85 |
| Rate for Payer: Aetna Commercial |
$490.02
|
| Rate for Payer: BCBS Trust/PPO |
$470.60
|
| Rate for Payer: BCN Commercial |
$445.52
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$495.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Healthscope Commercial |
$518.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: PHP Commercial |
$490.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.72
|
| Rate for Payer: Priority Health HMO/PPO |
$501.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.32
|
| Rate for Payer: UHC Core |
$481.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.38
|
|
|
HC G TUBE REPLACEMENT
|
Facility
|
OP
|
$576.50
|
|
| Hospital Charge Code |
36000046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$136.92 |
| Max. Negotiated Rate |
$518.85 |
| Rate for Payer: Aetna Commercial |
$490.02
|
| Rate for Payer: Aetna Medicare |
$149.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.16
|
| Rate for Payer: BCBS Complete |
$230.60
|
| Rate for Payer: BCBS MAPPO |
$144.12
|
| Rate for Payer: BCBS Trust/PPO |
$473.94
|
| Rate for Payer: BCN Commercial |
$448.23
|
| Rate for Payer: BCN Medicare Advantage |
$144.12
|
| Rate for Payer: Cash Price |
$461.20
|
| Rate for Payer: Cofinity Commercial |
$495.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.12
|
| Rate for Payer: Healthscope Commercial |
$518.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.02
|
| Rate for Payer: Nomi Health Commercial |
$472.73
|
| Rate for Payer: PACE Senior Care Partners |
$136.92
|
| Rate for Payer: PACE SWMI |
$144.12
|
| Rate for Payer: PHP Commercial |
$490.02
|
| Rate for Payer: PHP Medicare Advantage |
$144.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.72
|
| Rate for Payer: Priority Health HMO/PPO |
$501.56
|
| Rate for Payer: Priority Health Medicare |
$145.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.26
|
| Rate for Payer: Railroad Medicare Medicare |
$144.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.32
|
| Rate for Payer: UHC Core |
$481.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.12
|
| Rate for Payer: UHC Exchange |
$144.12
|
| Rate for Payer: UHC Medicare Advantage |
$144.12
|
| Rate for Payer: VA VA |
$144.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.38
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
IP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,783.92 |
| Max. Negotiated Rate |
$5,239.27 |
| Rate for Payer: Aetna Commercial |
$4,948.20
|
| Rate for Payer: BCBS Trust/PPO |
$4,752.02
|
| Rate for Payer: BCN Commercial |
$4,498.79
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,006.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Healthscope Commercial |
$5,239.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,366.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: PHP Commercial |
$4,948.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: Priority Health HMO/PPO |
$5,064.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,900.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,122.84
|
| Rate for Payer: UHC Core |
$4,860.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,366.06
|
|
|
HC GUIDANT CAROTID STENT
|
Facility
|
OP
|
$5,821.41
|
|
| Hospital Charge Code |
27800044
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,382.58 |
| Max. Negotiated Rate |
$5,239.27 |
| Rate for Payer: Aetna Commercial |
$4,948.20
|
| Rate for Payer: Aetna Medicare |
$1,513.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,819.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,819.19
|
| Rate for Payer: BCBS Complete |
$2,328.56
|
| Rate for Payer: BCBS MAPPO |
$1,455.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,785.78
|
| Rate for Payer: BCN Commercial |
$4,526.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,455.35
|
| Rate for Payer: Cash Price |
$4,657.13
|
| Rate for Payer: Cofinity Commercial |
$5,006.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,657.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,455.35
|
| Rate for Payer: Healthscope Commercial |
$5,239.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,366.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,528.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,673.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,948.20
|
| Rate for Payer: Nomi Health Commercial |
$4,773.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,382.58
|
| Rate for Payer: PACE SWMI |
$1,455.35
|
| Rate for Payer: PHP Commercial |
$4,948.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,455.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,783.92
|
| Rate for Payer: Priority Health HMO/PPO |
$5,064.63
|
| Rate for Payer: Priority Health Medicare |
$1,469.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,900.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,455.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,122.84
|
| Rate for Payer: UHC Core |
$4,860.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,455.35
|
| Rate for Payer: UHC Exchange |
$1,455.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,455.35
|
| Rate for Payer: VA VA |
$1,455.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,366.06
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
IP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,729.45 |
| Max. Negotiated Rate |
$9,317.70 |
| Rate for Payer: Aetna Commercial |
$8,800.05
|
| Rate for Payer: BCBS Trust/PPO |
$8,451.15
|
| Rate for Payer: BCN Commercial |
$8,000.80
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$8,903.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Healthscope Commercial |
$9,317.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,764.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: PHP Commercial |
$8,800.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: Priority Health HMO/PPO |
$9,007.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,936.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,110.64
|
| Rate for Payer: UHC Core |
$8,644.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,764.75
|
|
|
HC GUIDANT CRT LEAD
|
Facility
|
OP
|
$10,353.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800013
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,458.84 |
| Max. Negotiated Rate |
$9,317.70 |
| Rate for Payer: Aetna Commercial |
$8,800.05
|
| Rate for Payer: Aetna Medicare |
$2,691.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,235.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,235.31
|
| Rate for Payer: BCBS Complete |
$4,141.20
|
| Rate for Payer: BCBS MAPPO |
$2,588.25
|
| Rate for Payer: BCBS Trust/PPO |
$8,511.20
|
| Rate for Payer: BCN Commercial |
$8,049.46
|
| Rate for Payer: BCN Medicare Advantage |
$2,588.25
|
| Rate for Payer: Cash Price |
$8,282.40
|
| Rate for Payer: Cofinity Commercial |
$8,903.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,282.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,588.25
|
| Rate for Payer: Healthscope Commercial |
$9,317.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,764.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,717.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,976.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,800.05
|
| Rate for Payer: Nomi Health Commercial |
$8,489.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,458.84
|
| Rate for Payer: PACE SWMI |
$2,588.25
|
| Rate for Payer: PHP Commercial |
$8,800.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,588.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,729.45
|
| Rate for Payer: Priority Health HMO/PPO |
$9,007.11
|
| Rate for Payer: Priority Health Medicare |
$2,614.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,936.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,588.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,110.64
|
| Rate for Payer: UHC Core |
$8,644.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,588.25
|
| Rate for Payer: UHC Exchange |
$2,588.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,588.25
|
| Rate for Payer: VA VA |
$2,588.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,764.75
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
IP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,614.36 |
| Max. Negotiated Rate |
$11,927.57 |
| Rate for Payer: Aetna Commercial |
$11,264.93
|
| Rate for Payer: BCBS Trust/PPO |
$10,818.31
|
| Rate for Payer: BCN Commercial |
$10,241.81
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$11,397.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Healthscope Commercial |
$11,927.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,939.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: PHP Commercial |
$11,264.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: Priority Health HMO/PPO |
$11,529.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,879.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,662.52
|
| Rate for Payer: UHC Core |
$11,066.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,939.64
|
|
|
HC GUIDANT TACHY (ICD) LEAD
|
Facility
|
OP
|
$13,252.86
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,147.55 |
| Max. Negotiated Rate |
$11,927.57 |
| Rate for Payer: Aetna Commercial |
$11,264.93
|
| Rate for Payer: Aetna Medicare |
$3,445.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,141.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,141.52
|
| Rate for Payer: BCBS Complete |
$5,301.14
|
| Rate for Payer: BCBS MAPPO |
$3,313.22
|
| Rate for Payer: BCBS Trust/PPO |
$10,895.18
|
| Rate for Payer: BCN Commercial |
$10,304.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,313.22
|
| Rate for Payer: Cash Price |
$10,602.29
|
| Rate for Payer: Cofinity Commercial |
$11,397.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,602.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,313.22
|
| Rate for Payer: Healthscope Commercial |
$11,927.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,939.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,478.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,810.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,264.93
|
| Rate for Payer: Nomi Health Commercial |
$10,867.35
|
| Rate for Payer: PACE Senior Care Partners |
$3,147.55
|
| Rate for Payer: PACE SWMI |
$3,313.22
|
| Rate for Payer: PHP Commercial |
$11,264.93
|
| Rate for Payer: PHP Medicare Advantage |
$3,313.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,614.36
|
| Rate for Payer: Priority Health HMO/PPO |
$11,529.99
|
| Rate for Payer: Priority Health Medicare |
$3,346.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,879.42
|
| Rate for Payer: Railroad Medicare Medicare |
$3,313.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,662.52
|
| Rate for Payer: UHC Core |
$11,066.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,313.22
|
| Rate for Payer: UHC Exchange |
$3,313.22
|
| Rate for Payer: UHC Medicare Advantage |
$3,313.22
|
| Rate for Payer: VA VA |
$3,313.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,939.64
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
IP
|
$534.58
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$347.48 |
| Max. Negotiated Rate |
$481.12 |
| Rate for Payer: Aetna Commercial |
$454.39
|
| Rate for Payer: BCBS Trust/PPO |
$436.38
|
| Rate for Payer: BCN Commercial |
$413.12
|
| Rate for Payer: Cash Price |
$427.66
|
| Rate for Payer: Cofinity Commercial |
$459.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.66
|
| Rate for Payer: Healthscope Commercial |
$481.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.39
|
| Rate for Payer: Nomi Health Commercial |
$438.36
|
| Rate for Payer: PHP Commercial |
$454.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.48
|
| Rate for Payer: Priority Health HMO/PPO |
$465.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Core |
$446.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.94
|
|
|
HC GUIDED DRAIN CATH PLACEMENT
|
Facility
|
OP
|
$534.58
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
32000229
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$481.12 |
| Rate for Payer: Aetna Commercial |
$454.39
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.06
|
| Rate for Payer: BCBS Complete |
$213.83
|
| Rate for Payer: BCBS MAPPO |
$133.64
|
| Rate for Payer: BCBS Trust/PPO |
$439.48
|
| Rate for Payer: BCN Commercial |
$415.64
|
| Rate for Payer: BCN Medicare Advantage |
$133.64
|
| Rate for Payer: Cash Price |
$427.66
|
| Rate for Payer: Cofinity Commercial |
$459.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.64
|
| Rate for Payer: Healthscope Commercial |
$481.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.39
|
| Rate for Payer: Nomi Health Commercial |
$438.36
|
| Rate for Payer: PACE Senior Care Partners |
$126.96
|
| Rate for Payer: PACE SWMI |
$133.64
|
| Rate for Payer: PHP Commercial |
$454.39
|
| Rate for Payer: PHP Medicare Advantage |
$133.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.48
|
| Rate for Payer: Priority Health HMO/PPO |
$465.08
|
| Rate for Payer: Priority Health Medicare |
$134.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.17
|
| Rate for Payer: Railroad Medicare Medicare |
$133.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Core |
$446.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.64
|
| Rate for Payer: UHC Exchange |
$133.64
|
| Rate for Payer: UHC Medicare Advantage |
$133.64
|
| Rate for Payer: VA VA |
$133.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.94
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
OP
|
$1,752.92
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$416.32 |
| Max. Negotiated Rate |
$1,577.63 |
| Rate for Payer: Aetna Commercial |
$1,489.98
|
| Rate for Payer: Aetna Medicare |
$455.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$547.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$547.79
|
| Rate for Payer: BCBS Complete |
$701.17
|
| Rate for Payer: BCBS MAPPO |
$438.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.08
|
| Rate for Payer: BCN Commercial |
$1,362.90
|
| Rate for Payer: BCN Medicare Advantage |
$438.23
|
| Rate for Payer: Cash Price |
$1,402.34
|
| Rate for Payer: Cofinity Commercial |
$1,507.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.23
|
| Rate for Payer: Healthscope Commercial |
$1,577.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,314.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$460.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$503.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,489.98
|
| Rate for Payer: Nomi Health Commercial |
$1,437.39
|
| Rate for Payer: PACE Senior Care Partners |
$416.32
|
| Rate for Payer: PACE SWMI |
$438.23
|
| Rate for Payer: PHP Commercial |
$1,489.98
|
| Rate for Payer: PHP Medicare Advantage |
$438.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,139.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,525.04
|
| Rate for Payer: Priority Health Medicare |
$442.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.46
|
| Rate for Payer: Railroad Medicare Medicare |
$438.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.57
|
| Rate for Payer: UHC Core |
$1,463.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$438.23
|
| Rate for Payer: UHC Exchange |
$438.23
|
| Rate for Payer: UHC Medicare Advantage |
$438.23
|
| Rate for Payer: VA VA |
$438.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,314.69
|
|
|
HC GUIDELINER CATHETER
|
Facility
|
IP
|
$1,752.92
|
|
| Hospital Charge Code |
27200126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,139.40 |
| Max. Negotiated Rate |
$1,577.63 |
| Rate for Payer: Aetna Commercial |
$1,489.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,430.91
|
| Rate for Payer: BCN Commercial |
$1,354.66
|
| Rate for Payer: Cash Price |
$1,402.34
|
| Rate for Payer: Cofinity Commercial |
$1,507.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.34
|
| Rate for Payer: Healthscope Commercial |
$1,577.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,314.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,489.98
|
| Rate for Payer: Nomi Health Commercial |
$1,437.39
|
| Rate for Payer: PHP Commercial |
$1,489.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,139.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,525.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,542.57
|
| Rate for Payer: UHC Core |
$1,463.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,314.69
|
|
|
HC GUIDEWIRE
|
Facility
|
OP
|
$49.38
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.73 |
| Max. Negotiated Rate |
$44.44 |
| Rate for Payer: Aetna Commercial |
$41.97
|
| Rate for Payer: Aetna Medicare |
$12.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.43
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$12.34
|
| Rate for Payer: BCBS Trust/PPO |
$40.60
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$12.34
|
| Rate for Payer: Cash Price |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$42.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.34
|
| Rate for Payer: Healthscope Commercial |
$44.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.97
|
| Rate for Payer: Nomi Health Commercial |
$40.49
|
| Rate for Payer: PACE Senior Care Partners |
$11.73
|
| Rate for Payer: PACE SWMI |
$12.34
|
| Rate for Payer: PHP Commercial |
$41.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.10
|
| Rate for Payer: Priority Health HMO/PPO |
$42.96
|
| Rate for Payer: Priority Health Medicare |
$12.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.45
|
| Rate for Payer: UHC Core |
$41.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.34
|
| Rate for Payer: UHC Exchange |
$12.34
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$12.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.04
|
|
|
HC GUIDEWIRE
|
Facility
|
IP
|
$49.38
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200045
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.10 |
| Max. Negotiated Rate |
$44.44 |
| Rate for Payer: Aetna Commercial |
$41.97
|
| Rate for Payer: BCBS Trust/PPO |
$40.31
|
| Rate for Payer: BCN Commercial |
$38.16
|
| Rate for Payer: Cash Price |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$42.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.50
|
| Rate for Payer: Healthscope Commercial |
$44.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.97
|
| Rate for Payer: Nomi Health Commercial |
$40.49
|
| Rate for Payer: PHP Commercial |
$41.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.10
|
| Rate for Payer: Priority Health HMO/PPO |
$42.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.45
|
| Rate for Payer: UHC Core |
$41.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.04
|
|
