|
HC GUIDE WIRE DILATATION
|
Facility
|
IP
|
$1,345.45
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$874.54 |
| Max. Negotiated Rate |
$1,210.90 |
| Rate for Payer: Aetna Commercial |
$1,143.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.29
|
| Rate for Payer: BCN Commercial |
$1,039.76
|
| Rate for Payer: Cash Price |
$1,076.36
|
| Rate for Payer: Cofinity Commercial |
$1,157.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,076.36
|
| Rate for Payer: Healthscope Commercial |
$1,210.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,009.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,143.63
|
| Rate for Payer: Nomi Health Commercial |
$1,103.27
|
| Rate for Payer: PHP Commercial |
$1,143.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,170.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$901.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.00
|
| Rate for Payer: UHC Core |
$1,123.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,009.09
|
|
|
HC GUIDE WIRE DILATATION
|
Facility
|
OP
|
$1,345.45
|
|
| Hospital Charge Code |
36000050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$319.54 |
| Max. Negotiated Rate |
$1,210.90 |
| Rate for Payer: Aetna Commercial |
$1,143.63
|
| Rate for Payer: Aetna Medicare |
$349.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$420.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$420.45
|
| Rate for Payer: BCBS Complete |
$538.18
|
| Rate for Payer: BCBS MAPPO |
$336.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,106.09
|
| Rate for Payer: BCN Commercial |
$1,046.09
|
| Rate for Payer: BCN Medicare Advantage |
$336.36
|
| Rate for Payer: Cash Price |
$1,076.36
|
| Rate for Payer: Cofinity Commercial |
$1,157.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,076.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.36
|
| Rate for Payer: Healthscope Commercial |
$1,210.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,009.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$386.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,143.63
|
| Rate for Payer: Nomi Health Commercial |
$1,103.27
|
| Rate for Payer: PACE Senior Care Partners |
$319.54
|
| Rate for Payer: PACE SWMI |
$336.36
|
| Rate for Payer: PHP Commercial |
$1,143.63
|
| Rate for Payer: PHP Medicare Advantage |
$336.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$874.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,170.54
|
| Rate for Payer: Priority Health Medicare |
$339.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$901.45
|
| Rate for Payer: Railroad Medicare Medicare |
$336.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.00
|
| Rate for Payer: UHC Core |
$1,123.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$336.36
|
| Rate for Payer: UHC Exchange |
$336.36
|
| Rate for Payer: UHC Medicare Advantage |
$336.36
|
| Rate for Payer: VA VA |
$336.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,009.09
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.86
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCBS Trust/PPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$61.86
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Medicare |
$20.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.89
|
| Rate for Payer: UHC Exchange |
$19.89
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
| Rate for Payer: VA VA |
$19.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 1
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200273
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: BCBS Trust/PPO |
$64.94
|
| Rate for Payer: BCN Commercial |
$61.48
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
OP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$350.31 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: Aetna Medicare |
$383.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$460.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$460.94
|
| Rate for Payer: BCBS Complete |
$590.00
|
| Rate for Payer: BCBS MAPPO |
$368.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.60
|
| Rate for Payer: BCN Commercial |
$1,146.81
|
| Rate for Payer: BCN Medicare Advantage |
$368.75
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.75
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: PACE Senior Care Partners |
$350.31
|
| Rate for Payer: PACE SWMI |
$368.75
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: PHP Medicare Advantage |
$368.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,283.25
|
| Rate for Payer: Priority Health Medicare |
$372.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.25
|
| Rate for Payer: Railroad Medicare Medicare |
$368.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.00
|
| Rate for Payer: UHC Core |
$1,231.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.75
|
| Rate for Payer: UHC Exchange |
$368.75
|
| Rate for Payer: UHC Medicare Advantage |
$368.75
|
| Rate for Payer: VA VA |
$368.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.25
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 14
|
Facility
|
IP
|
$1,475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$958.75 |
| Max. Negotiated Rate |
$1,327.50 |
| Rate for Payer: Aetna Commercial |
$1,253.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.04
|
| Rate for Payer: BCN Commercial |
$1,139.88
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cofinity Commercial |
$1,268.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.00
|
| Rate for Payer: Healthscope Commercial |
$1,327.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.75
|
| Rate for Payer: Nomi Health Commercial |
$1,209.50
|
| Rate for Payer: PHP Commercial |
$1,253.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$958.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,283.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.00
|
| Rate for Payer: UHC Core |
$1,231.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.25
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$101.44 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$127.39
|
| Rate for Payer: BCN Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.04
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 2
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200086
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$121.34
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.56
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.02
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.04
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
OP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.07 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: Aetna Medicare |
$84.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.41
|
| Rate for Payer: BCBS Complete |
$129.80
|
| Rate for Payer: BCBS MAPPO |
$81.13
|
| Rate for Payer: BCBS Trust/PPO |
$266.78
|
| Rate for Payer: BCN Commercial |
$252.31
|
| Rate for Payer: BCN Medicare Advantage |
$81.13
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.13
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: PACE Senior Care Partners |
$77.07
|
| Rate for Payer: PACE SWMI |
$81.13
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: PHP Medicare Advantage |
$81.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.93
|
| Rate for Payer: Priority Health HMO/PPO |
$282.32
|
| Rate for Payer: Priority Health Medicare |
$81.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.42
|
| Rate for Payer: Railroad Medicare Medicare |
$81.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.57
|
| Rate for Payer: UHC Core |
$270.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.13
|
| Rate for Payer: UHC Exchange |
$81.13
|
| Rate for Payer: UHC Medicare Advantage |
$81.13
|
| Rate for Payer: VA VA |
$81.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.38
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL 3
|
Facility
|
IP
|
$324.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$210.93 |
| Max. Negotiated Rate |
$292.06 |
| Rate for Payer: Aetna Commercial |
$275.83
|
| Rate for Payer: BCBS Trust/PPO |
$264.90
|
| Rate for Payer: BCN Commercial |
$250.78
|
| Rate for Payer: Cash Price |
$259.61
|
| Rate for Payer: Cofinity Commercial |
$279.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.61
|
| Rate for Payer: Healthscope Commercial |
$292.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.83
|
| Rate for Payer: Nomi Health Commercial |
$266.10
|
| Rate for Payer: PHP Commercial |
$275.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.93
|
| Rate for Payer: Priority Health HMO/PPO |
$282.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.57
|
| Rate for Payer: UHC Core |
$270.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.38
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
OP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.74 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: Aetna Medicare |
$120.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.39
|
| Rate for Payer: BCBS Complete |
$184.82
|
| Rate for Payer: BCBS MAPPO |
$115.52
|
| Rate for Payer: BCBS Trust/PPO |
$379.86
|
| Rate for Payer: BCN Commercial |
$359.25
|
| Rate for Payer: BCN Medicare Advantage |
$115.52
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.52
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: PACE Senior Care Partners |
$109.74
|
| Rate for Payer: PACE SWMI |
$115.52
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: PHP Medicare Advantage |
$115.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO |
$401.99
|
| Rate for Payer: Priority Health Medicare |
$116.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$309.58
|
| Rate for Payer: Railroad Medicare Medicare |
$115.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.61
|
| Rate for Payer: UHC Core |
$385.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.52
|
| Rate for Payer: UHC Exchange |
$115.52
|
| Rate for Payer: UHC Medicare Advantage |
$115.52
|
| Rate for Payer: VA VA |
$115.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.54
|
|
|
HC GUIDEWIRE GLIDEWIRE LVL4
|
Facility
|
IP
|
$462.06
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200080
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$300.34 |
| Max. Negotiated Rate |
$415.85 |
| Rate for Payer: Aetna Commercial |
$392.75
|
| Rate for Payer: BCBS Trust/PPO |
$377.18
|
| Rate for Payer: BCN Commercial |
$357.08
|
| Rate for Payer: Cash Price |
$369.65
|
| Rate for Payer: Cofinity Commercial |
$397.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.65
|
| Rate for Payer: Healthscope Commercial |
$415.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.75
|
| Rate for Payer: Nomi Health Commercial |
$378.89
|
| Rate for Payer: PHP Commercial |
$392.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO |
$401.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$309.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.61
|
| Rate for Payer: UHC Core |
$385.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.54
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
IP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$436.57 |
| Max. Negotiated Rate |
$604.48 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: BCBS Trust/PPO |
$548.27
|
| Rate for Payer: BCN Commercial |
$519.05
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Healthscope Commercial |
$604.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.57
|
| Rate for Payer: Priority Health HMO/PPO |
$584.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.05
|
| Rate for Payer: UHC Core |
$560.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.74
|
|
|
HC GUIDEWIRE GLIDWIRE LVL 5
|
Facility
|
OP
|
$671.65
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$159.52 |
| Max. Negotiated Rate |
$604.48 |
| Rate for Payer: Aetna Commercial |
$570.90
|
| Rate for Payer: Aetna Medicare |
$174.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.89
|
| Rate for Payer: BCBS Complete |
$268.66
|
| Rate for Payer: BCBS MAPPO |
$167.91
|
| Rate for Payer: BCBS Trust/PPO |
$552.16
|
| Rate for Payer: BCN Commercial |
$522.21
|
| Rate for Payer: BCN Medicare Advantage |
$167.91
|
| Rate for Payer: Cash Price |
$537.32
|
| Rate for Payer: Cofinity Commercial |
$577.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.91
|
| Rate for Payer: Healthscope Commercial |
$604.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.90
|
| Rate for Payer: Nomi Health Commercial |
$550.75
|
| Rate for Payer: PACE Senior Care Partners |
$159.52
|
| Rate for Payer: PACE SWMI |
$167.91
|
| Rate for Payer: PHP Commercial |
$570.90
|
| Rate for Payer: PHP Medicare Advantage |
$167.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.57
|
| Rate for Payer: Priority Health HMO/PPO |
$584.34
|
| Rate for Payer: Priority Health Medicare |
$169.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.01
|
| Rate for Payer: Railroad Medicare Medicare |
$167.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.05
|
| Rate for Payer: UHC Core |
$560.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.91
|
| Rate for Payer: UHC Exchange |
$167.91
|
| Rate for Payer: UHC Medicare Advantage |
$167.91
|
| Rate for Payer: VA VA |
$167.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.74
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
IP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: BCBS Trust/PPO |
$35.83
|
| Rate for Payer: BCN Commercial |
$33.92
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.53
|
| Rate for Payer: Priority Health HMO/PPO |
$38.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.62
|
| Rate for Payer: UHC Core |
$36.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.92
|
|
|
HC GUIDING CATHETER LVL 1
|
Facility
|
OP
|
$43.89
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$39.50 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: Aetna Medicare |
$11.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$17.56
|
| Rate for Payer: BCBS MAPPO |
$10.97
|
| Rate for Payer: BCBS Trust/PPO |
$36.08
|
| Rate for Payer: BCN Commercial |
$34.12
|
| Rate for Payer: BCN Medicare Advantage |
$10.97
|
| Rate for Payer: Cash Price |
$35.11
|
| Rate for Payer: Cofinity Commercial |
$37.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.97
|
| Rate for Payer: Healthscope Commercial |
$39.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.31
|
| Rate for Payer: Nomi Health Commercial |
$35.99
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.97
|
| Rate for Payer: PHP Commercial |
$37.31
|
| Rate for Payer: PHP Medicare Advantage |
$10.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.53
|
| Rate for Payer: Priority Health HMO/PPO |
$38.18
|
| Rate for Payer: Priority Health Medicare |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.41
|
| Rate for Payer: Railroad Medicare Medicare |
$10.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.62
|
| Rate for Payer: UHC Core |
$36.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.97
|
| Rate for Payer: UHC Exchange |
$10.97
|
| Rate for Payer: UHC Medicare Advantage |
$10.97
|
| Rate for Payer: VA VA |
$10.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.92
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
OP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$424.89 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: Aetna Medicare |
$465.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$559.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$559.07
|
| Rate for Payer: BCBS Complete |
$715.60
|
| Rate for Payer: BCBS MAPPO |
$447.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.75
|
| Rate for Payer: BCN Commercial |
$1,390.96
|
| Rate for Payer: BCN Medicare Advantage |
$447.25
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.25
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: PACE Senior Care Partners |
$424.89
|
| Rate for Payer: PACE SWMI |
$447.25
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: PHP Medicare Advantage |
$447.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.44
|
| Rate for Payer: Priority Health Medicare |
$451.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.64
|
| Rate for Payer: Railroad Medicare Medicare |
$447.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.33
|
| Rate for Payer: UHC Core |
$1,493.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$447.25
|
| Rate for Payer: UHC Exchange |
$447.25
|
| Rate for Payer: UHC Medicare Advantage |
$447.25
|
| Rate for Payer: VA VA |
$447.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.76
|
|
|
HC GUIDING CATHETER LVL 17
|
Facility
|
IP
|
$1,789.01
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800082
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.86 |
| Max. Negotiated Rate |
$1,610.11 |
| Rate for Payer: Aetna Commercial |
$1,520.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.37
|
| Rate for Payer: BCN Commercial |
$1,382.55
|
| Rate for Payer: Cash Price |
$1,431.21
|
| Rate for Payer: Cofinity Commercial |
$1,538.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,431.21
|
| Rate for Payer: Healthscope Commercial |
$1,610.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.66
|
| Rate for Payer: Nomi Health Commercial |
$1,466.99
|
| Rate for Payer: PHP Commercial |
$1,520.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,574.33
|
| Rate for Payer: UHC Core |
$1,493.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.76
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
OP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$469.86 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: Aetna Medicare |
$514.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$618.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$618.24
|
| Rate for Payer: BCBS Complete |
$791.35
|
| Rate for Payer: BCBS MAPPO |
$494.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.42
|
| Rate for Payer: BCN Commercial |
$1,538.18
|
| Rate for Payer: BCN Medicare Advantage |
$494.59
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.59
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$568.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: PACE Senior Care Partners |
$469.86
|
| Rate for Payer: PACE SWMI |
$494.59
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: PHP Medicare Advantage |
$494.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,721.18
|
| Rate for Payer: Priority Health Medicare |
$499.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,325.51
|
| Rate for Payer: Railroad Medicare Medicare |
$494.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.97
|
| Rate for Payer: UHC Core |
$1,651.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$494.59
|
| Rate for Payer: UHC Exchange |
$494.59
|
| Rate for Payer: UHC Medicare Advantage |
$494.59
|
| Rate for Payer: VA VA |
$494.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.78
|
|
|
HC GUIDING CATHETER LVL19
|
Facility
|
IP
|
$1,978.37
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,285.94 |
| Max. Negotiated Rate |
$1,780.53 |
| Rate for Payer: Aetna Commercial |
$1,681.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.94
|
| Rate for Payer: BCN Commercial |
$1,528.88
|
| Rate for Payer: Cash Price |
$1,582.70
|
| Rate for Payer: Cofinity Commercial |
$1,701.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.70
|
| Rate for Payer: Healthscope Commercial |
$1,780.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,483.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.61
|
| Rate for Payer: Nomi Health Commercial |
$1,622.26
|
| Rate for Payer: PHP Commercial |
$1,681.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,285.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,721.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,325.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,740.97
|
| Rate for Payer: UHC Core |
$1,651.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,483.78
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
OP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.92 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: Aetna Medicare |
$74.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.37
|
| Rate for Payer: BCBS Complete |
$114.40
|
| Rate for Payer: BCBS MAPPO |
$71.50
|
| Rate for Payer: BCBS Trust/PPO |
$235.11
|
| Rate for Payer: BCN Commercial |
$222.36
|
| Rate for Payer: BCN Medicare Advantage |
$71.50
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.50
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: PACE Senior Care Partners |
$67.92
|
| Rate for Payer: PACE SWMI |
$71.50
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: PHP Medicare Advantage |
$71.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.89
|
| Rate for Payer: Priority Health HMO/PPO |
$248.81
|
| Rate for Payer: Priority Health Medicare |
$72.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.61
|
| Rate for Payer: Railroad Medicare Medicare |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.67
|
| Rate for Payer: UHC Core |
$238.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.50
|
| Rate for Payer: UHC Exchange |
$71.50
|
| Rate for Payer: UHC Medicare Advantage |
$71.50
|
| Rate for Payer: VA VA |
$71.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
|
|
HC GUIDING CATHETER LVL 2
|
Facility
|
IP
|
$285.99
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$185.89 |
| Max. Negotiated Rate |
$257.39 |
| Rate for Payer: Aetna Commercial |
$243.09
|
| Rate for Payer: BCBS Trust/PPO |
$233.45
|
| Rate for Payer: BCN Commercial |
$221.01
|
| Rate for Payer: Cash Price |
$228.79
|
| Rate for Payer: Cofinity Commercial |
$245.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.79
|
| Rate for Payer: Healthscope Commercial |
$257.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.09
|
| Rate for Payer: Nomi Health Commercial |
$234.51
|
| Rate for Payer: PHP Commercial |
$243.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.89
|
| Rate for Payer: Priority Health HMO/PPO |
$248.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.67
|
| Rate for Payer: UHC Core |
$238.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.49
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
IP
|
$2,477.72
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,610.52 |
| Max. Negotiated Rate |
$2,229.95 |
| Rate for Payer: Aetna Commercial |
$2,106.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,022.56
|
| Rate for Payer: BCN Commercial |
$1,914.78
|
| Rate for Payer: Cash Price |
$1,982.18
|
| Rate for Payer: Cofinity Commercial |
$2,130.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,982.18
|
| Rate for Payer: Healthscope Commercial |
$2,229.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,858.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,106.06
|
| Rate for Payer: Nomi Health Commercial |
$2,031.73
|
| Rate for Payer: PHP Commercial |
$2,106.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,610.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,155.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,660.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,180.39
|
| Rate for Payer: UHC Core |
$2,068.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,858.29
|
|
|
HC GUIDING CATHETER LVL 24
|
Facility
|
OP
|
$2,477.72
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200079
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$588.46 |
| Max. Negotiated Rate |
$2,229.95 |
| Rate for Payer: Aetna Commercial |
$2,106.06
|
| Rate for Payer: Aetna Medicare |
$644.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$774.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$774.29
|
| Rate for Payer: BCBS Complete |
$991.09
|
| Rate for Payer: BCBS MAPPO |
$619.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.93
|
| Rate for Payer: BCN Commercial |
$1,926.43
|
| Rate for Payer: BCN Medicare Advantage |
$619.43
|
| Rate for Payer: Cash Price |
$1,982.18
|
| Rate for Payer: Cofinity Commercial |
$2,130.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,982.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$619.43
|
| Rate for Payer: Healthscope Commercial |
$2,229.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,858.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$650.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$712.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,106.06
|
| Rate for Payer: Nomi Health Commercial |
$2,031.73
|
| Rate for Payer: PACE Senior Care Partners |
$588.46
|
| Rate for Payer: PACE SWMI |
$619.43
|
| Rate for Payer: PHP Commercial |
$2,106.06
|
| Rate for Payer: PHP Medicare Advantage |
$619.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,610.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,155.62
|
| Rate for Payer: Priority Health Medicare |
$625.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,660.07
|
| Rate for Payer: Railroad Medicare Medicare |
$619.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,180.39
|
| Rate for Payer: UHC Core |
$2,068.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$619.43
|
| Rate for Payer: UHC Exchange |
$619.43
|
| Rate for Payer: UHC Medicare Advantage |
$619.43
|
| Rate for Payer: VA VA |
$619.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,858.29
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.38 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: BCBS Trust/PPO |
$275.50
|
| Rate for Payer: BCN Commercial |
$260.82
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: Priority Health HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
