|
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 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 |
$346.55
|
| 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 |
$346.55
|
|
|
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 |
$346.55
|
| 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 |
$346.55
|
|
|
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 |
$604.49 |
| 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 |
$604.49
|
| 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 |
$604.49 |
| 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 |
$604.49
|
| 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
|
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 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 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
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: Aetna Medicare |
$87.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.47
|
| Rate for Payer: BCBS Complete |
$135.00
|
| Rate for Payer: BCBS MAPPO |
$84.38
|
| Rate for Payer: BCBS Trust/PPO |
$277.46
|
| Rate for Payer: BCN Commercial |
$262.41
|
| Rate for Payer: BCN Medicare Advantage |
$84.38
|
| 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: Health Alliance Plan Medicare Advantage |
$84.38
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: PACE Senior Care Partners |
$80.16
|
| Rate for Payer: PACE SWMI |
$84.38
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: PHP Medicare Advantage |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: Priority Health HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Medicare |
$85.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.12
|
| Rate for Payer: Railroad Medicare Medicare |
$84.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.38
|
| Rate for Payer: UHC Exchange |
$84.38
|
| Rate for Payer: UHC Medicare Advantage |
$84.38
|
| Rate for Payer: VA VA |
$84.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
OP
|
$3,592.55
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$853.23 |
| Max. Negotiated Rate |
$3,233.30 |
| Rate for Payer: Aetna Commercial |
$3,053.67
|
| Rate for Payer: Aetna Medicare |
$934.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,122.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,122.67
|
| Rate for Payer: BCBS Complete |
$1,437.02
|
| Rate for Payer: BCBS MAPPO |
$898.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,953.44
|
| Rate for Payer: BCN Commercial |
$2,793.21
|
| Rate for Payer: BCN Medicare Advantage |
$898.14
|
| Rate for Payer: Cash Price |
$2,874.04
|
| Rate for Payer: Cofinity Commercial |
$3,089.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,874.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$898.14
|
| Rate for Payer: Healthscope Commercial |
$3,233.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,694.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$943.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,053.67
|
| Rate for Payer: Nomi Health Commercial |
$2,945.89
|
| Rate for Payer: PACE Senior Care Partners |
$853.23
|
| Rate for Payer: PACE SWMI |
$898.14
|
| Rate for Payer: PHP Commercial |
$3,053.67
|
| Rate for Payer: PHP Medicare Advantage |
$898.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,335.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,125.52
|
| Rate for Payer: Priority Health Medicare |
$907.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,407.01
|
| Rate for Payer: Railroad Medicare Medicare |
$898.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,161.44
|
| Rate for Payer: UHC Core |
$2,999.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$898.14
|
| Rate for Payer: UHC Exchange |
$898.14
|
| Rate for Payer: UHC Medicare Advantage |
$898.14
|
| Rate for Payer: VA VA |
$898.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,694.41
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
IP
|
$3,592.55
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,335.16 |
| Max. Negotiated Rate |
$3,233.30 |
| Rate for Payer: Aetna Commercial |
$3,053.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,932.60
|
| Rate for Payer: BCN Commercial |
$2,776.32
|
| Rate for Payer: Cash Price |
$2,874.04
|
| Rate for Payer: Cofinity Commercial |
$3,089.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,874.04
|
| Rate for Payer: Healthscope Commercial |
$3,233.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,694.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,053.67
|
| Rate for Payer: Nomi Health Commercial |
$2,945.89
|
| Rate for Payer: PHP Commercial |
$3,053.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,335.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,125.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,407.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,161.44
|
| Rate for Payer: UHC Core |
$2,999.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,694.41
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
OP
|
$490.52
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.50 |
| Max. Negotiated Rate |
$441.47 |
| Rate for Payer: Aetna Commercial |
$416.94
|
| Rate for Payer: Aetna Medicare |
$127.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.29
|
| Rate for Payer: BCBS Complete |
$196.21
|
| Rate for Payer: BCBS MAPPO |
$122.63
|
| Rate for Payer: BCBS Trust/PPO |
$403.26
|
| Rate for Payer: BCN Commercial |
$381.38
|
| Rate for Payer: BCN Medicare Advantage |
$122.63
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cofinity Commercial |
$421.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.63
|
| Rate for Payer: Healthscope Commercial |
$441.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.94
|
| Rate for Payer: Nomi Health Commercial |
$402.23
|
| Rate for Payer: PACE Senior Care Partners |
$116.50
|
| Rate for Payer: PACE SWMI |
$122.63
|
| Rate for Payer: PHP Commercial |
$416.94
|
| Rate for Payer: PHP Medicare Advantage |
$122.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.84
|
| Rate for Payer: Priority Health HMO/PPO |
$426.75
|
| Rate for Payer: Priority Health Medicare |
$123.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.65
|
| Rate for Payer: Railroad Medicare Medicare |
$122.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.66
|
| Rate for Payer: UHC Core |
$409.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.63
|
| Rate for Payer: UHC Exchange |
$122.63
|
| Rate for Payer: UHC Medicare Advantage |
$122.63
|
| Rate for Payer: VA VA |
$122.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.89
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
IP
|
$490.52
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$318.84 |
| Max. Negotiated Rate |
$441.47 |
| Rate for Payer: Aetna Commercial |
$416.94
|
| Rate for Payer: BCBS Trust/PPO |
$400.41
|
| Rate for Payer: BCN Commercial |
$379.07
|
| Rate for Payer: Cash Price |
$392.42
|
| Rate for Payer: Cofinity Commercial |
$421.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.42
|
| Rate for Payer: Healthscope Commercial |
$441.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.94
|
| Rate for Payer: Nomi Health Commercial |
$402.23
|
| Rate for Payer: PHP Commercial |
$416.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.84
|
| Rate for Payer: Priority Health HMO/PPO |
$426.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.66
|
| Rate for Payer: UHC Core |
$409.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.89
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
OP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,020.19 |
| Max. Negotiated Rate |
$3,865.98 |
| Rate for Payer: Aetna Commercial |
$3,651.20
|
| Rate for Payer: Aetna Medicare |
$1,116.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,342.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,342.35
|
| Rate for Payer: BCBS Complete |
$1,718.21
|
| Rate for Payer: BCBS MAPPO |
$1,073.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,531.36
|
| Rate for Payer: BCN Commercial |
$3,339.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,073.88
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$3,694.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,073.88
|
| Rate for Payer: Healthscope Commercial |
$3,865.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,221.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,127.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,234.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,651.20
|
| Rate for Payer: Nomi Health Commercial |
$3,522.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,020.19
|
| Rate for Payer: PACE SWMI |
$1,073.88
|
| Rate for Payer: PHP Commercial |
$3,651.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,073.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,792.09
|
| Rate for Payer: Priority Health HMO/PPO |
$3,737.11
|
| Rate for Payer: Priority Health Medicare |
$1,084.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,878.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,073.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,780.07
|
| Rate for Payer: UHC Core |
$3,586.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,073.88
|
| Rate for Payer: UHC Exchange |
$1,073.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,073.88
|
| Rate for Payer: VA VA |
$1,073.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,221.65
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
IP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,792.09 |
| Max. Negotiated Rate |
$3,865.98 |
| Rate for Payer: Aetna Commercial |
$3,651.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,506.44
|
| Rate for Payer: BCN Commercial |
$3,319.59
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$3,694.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Healthscope Commercial |
$3,865.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,221.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,651.20
|
| Rate for Payer: Nomi Health Commercial |
$3,522.33
|
| Rate for Payer: PHP Commercial |
$3,651.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,792.09
|
| Rate for Payer: Priority Health HMO/PPO |
$3,737.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,878.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,780.07
|
| Rate for Payer: UHC Core |
$3,586.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,221.65
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
OP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,356.64 |
| Max. Negotiated Rate |
$5,140.94 |
| Rate for Payer: Aetna Commercial |
$4,855.33
|
| Rate for Payer: Aetna Medicare |
$1,485.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.05
|
| Rate for Payer: BCBS Complete |
$2,284.86
|
| Rate for Payer: BCBS MAPPO |
$1,428.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,695.96
|
| Rate for Payer: BCN Commercial |
$4,441.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.04
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$4,912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.04
|
| Rate for Payer: Healthscope Commercial |
$5,140.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,499.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,855.33
|
| Rate for Payer: Nomi Health Commercial |
$4,683.96
|
| Rate for Payer: PACE Senior Care Partners |
$1,356.64
|
| Rate for Payer: PACE SWMI |
$1,428.04
|
| Rate for Payer: PHP Commercial |
$4,855.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,712.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,969.57
|
| Rate for Payer: Priority Health Medicare |
$1,442.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,827.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.69
|
| Rate for Payer: UHC Core |
$4,769.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.04
|
| Rate for Payer: UHC Exchange |
$1,428.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,428.04
|
| Rate for Payer: VA VA |
$1,428.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.11
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
IP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,712.90 |
| Max. Negotiated Rate |
$5,140.94 |
| Rate for Payer: Aetna Commercial |
$4,855.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,662.83
|
| Rate for Payer: BCN Commercial |
$4,414.35
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$4,912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Healthscope Commercial |
$5,140.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,855.33
|
| Rate for Payer: Nomi Health Commercial |
$4,683.96
|
| Rate for Payer: PHP Commercial |
$4,855.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,712.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,969.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,827.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.69
|
| Rate for Payer: UHC Core |
$4,769.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.11
|
|
