|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,278.44 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna Medicare |
$3,175.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,816.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,816.37
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$3,053.10
|
| Rate for Payer: BCBS Trust/PPO |
$10,039.81
|
| Rate for Payer: BCN Commercial |
$9,495.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,053.10
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,053.10
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,205.75
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,511.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: PACE Senior Care Partners |
$2,900.44
|
| Rate for Payer: PACE SWMI |
$3,053.10
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,053.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,624.78
|
| Rate for Payer: Priority Health Medicare |
$3,083.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,182.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,053.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,746.90
|
| Rate for Payer: UHC Core |
$10,197.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,053.10
|
| Rate for Payer: UHC Exchange |
$3,053.10
|
| Rate for Payer: UHC Medicare Advantage |
$3,053.10
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$3,053.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,938.05 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: BCBS Trust/PPO |
$9,968.97
|
| Rate for Payer: BCN Commercial |
$9,437.73
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,624.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,182.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,746.90
|
| Rate for Payer: UHC Core |
$10,197.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: BCBS Trust/PPO |
$44.55
|
| Rate for Payer: BCN Commercial |
$42.18
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO |
$47.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.03
|
| Rate for Payer: UHC Core |
$45.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$14.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.06
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: BCBS MAPPO |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$44.87
|
| Rate for Payer: BCN Commercial |
$42.44
|
| Rate for Payer: BCN Medicare Advantage |
$13.64
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: PACE Senior Care Partners |
$12.96
|
| Rate for Payer: PACE SWMI |
$13.64
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO |
$47.48
|
| Rate for Payer: Priority Health Medicare |
$13.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.57
|
| Rate for Payer: Railroad Medicare Medicare |
$13.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.03
|
| Rate for Payer: UHC Core |
$45.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.64
|
| Rate for Payer: UHC Exchange |
$13.64
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,512.67 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: BCBS Trust/PPO |
$6,923.06
|
| Rate for Payer: BCN Commercial |
$6,554.14
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: Nomi Health Commercial |
$6,954.44
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health HMO/PPO |
$7,378.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,682.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,463.31
|
| Rate for Payer: UHC Core |
$7,081.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,014.24 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna Medicare |
$2,205.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,650.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,650.32
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$2,120.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,972.25
|
| Rate for Payer: BCN Commercial |
$6,594.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,120.26
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,120.26
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,226.27
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,438.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: Nomi Health Commercial |
$6,954.44
|
| Rate for Payer: PACE Senior Care Partners |
$2,014.24
|
| Rate for Payer: PACE SWMI |
$2,120.26
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,120.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health HMO/PPO |
$7,378.50
|
| Rate for Payer: Priority Health Medicare |
$2,141.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,682.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,120.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,463.31
|
| Rate for Payer: UHC Core |
$7,081.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,120.26
|
| Rate for Payer: UHC Exchange |
$2,120.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,120.26
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$2,120.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,278.44 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna Medicare |
$3,926.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,718.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,718.95
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$3,775.16
|
| Rate for Payer: BCBS Trust/PPO |
$12,414.24
|
| Rate for Payer: BCN Commercial |
$11,740.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,775.16
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,775.16
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,963.92
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,341.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: Nomi Health Commercial |
$12,382.53
|
| Rate for Payer: PACE Senior Care Partners |
$3,586.40
|
| Rate for Payer: PACE SWMI |
$3,775.16
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,775.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health HMO/PPO |
$13,137.57
|
| Rate for Payer: Priority Health Medicare |
$3,812.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,117.44
|
| Rate for Payer: Railroad Medicare Medicare |
$3,775.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,288.57
|
| Rate for Payer: UHC Core |
$12,609.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,775.16
|
| Rate for Payer: UHC Exchange |
$3,775.16
|
| Rate for Payer: UHC Medicare Advantage |
$3,775.16
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$3,775.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,815.42 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: BCBS Trust/PPO |
$12,326.66
|
| Rate for Payer: BCN Commercial |
$11,669.78
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: Nomi Health Commercial |
$12,382.53
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health HMO/PPO |
$13,137.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,117.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,288.57
|
| Rate for Payer: UHC Core |
$12,609.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,296.98 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: BCBS Trust/PPO |
$10,419.73
|
| Rate for Payer: BCN Commercial |
$9,864.47
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,573.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: Nomi Health Commercial |
$10,466.96
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health HMO/PPO |
$11,105.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,552.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,232.83
|
| Rate for Payer: UHC Core |
$10,658.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,573.44
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,278.44 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: Aetna Medicare |
$3,318.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,988.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,988.93
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$3,191.14
|
| Rate for Payer: BCBS Trust/PPO |
$10,493.76
|
| Rate for Payer: BCN Commercial |
$9,924.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,191.14
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,191.14
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,573.44
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,350.70
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,669.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: Nomi Health Commercial |
$10,466.96
|
| Rate for Payer: PACE Senior Care Partners |
$3,031.59
|
| Rate for Payer: PACE SWMI |
$3,191.14
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,191.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health HMO/PPO |
$11,105.18
|
| Rate for Payer: Priority Health Medicare |
$3,223.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,552.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,191.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,232.83
|
| Rate for Payer: UHC Core |
$10,658.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,191.14
|
| Rate for Payer: UHC Exchange |
$3,191.14
|
| Rate for Payer: UHC Medicare Advantage |
$3,191.14
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$3,191.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,573.44
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,128.38 |
| Max. Negotiated Rate |
$8,065.45 |
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: Aetna Medicare |
$2,330.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,800.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,800.50
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$2,240.40
|
| Rate for Payer: BCBS Trust/PPO |
$7,367.34
|
| Rate for Payer: BCN Commercial |
$6,967.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,240.40
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,240.40
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,721.21
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,352.42
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,576.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: Nomi Health Commercial |
$7,348.52
|
| Rate for Payer: PACE Senior Care Partners |
$2,128.38
|
| Rate for Payer: PACE SWMI |
$2,240.40
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: PHP Medicare Advantage |
$2,240.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health HMO/PPO |
$7,796.60
|
| Rate for Payer: Priority Health Medicare |
$2,262.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,004.28
|
| Rate for Payer: Railroad Medicare Medicare |
$2,240.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,886.22
|
| Rate for Payer: UHC Core |
$7,482.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,240.40
|
| Rate for Payer: UHC Exchange |
$2,240.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,240.40
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$2,240.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,721.21
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,825.05 |
| Max. Negotiated Rate |
$8,065.45 |
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: BCBS Trust/PPO |
$7,315.36
|
| Rate for Payer: BCN Commercial |
$6,925.53
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,721.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: Nomi Health Commercial |
$7,348.52
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health HMO/PPO |
$7,796.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,004.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,886.22
|
| Rate for Payer: UHC Core |
$7,482.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,721.21
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,278.44 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: Aetna Medicare |
$3,341.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,015.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,015.66
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$3,212.53
|
| Rate for Payer: BCBS Trust/PPO |
$10,564.08
|
| Rate for Payer: BCN Commercial |
$9,990.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,212.53
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,212.53
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,637.58
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,373.15
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,694.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: Nomi Health Commercial |
$10,537.09
|
| Rate for Payer: PACE Senior Care Partners |
$3,051.90
|
| Rate for Payer: PACE SWMI |
$3,212.53
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: PHP Medicare Advantage |
$3,212.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health HMO/PPO |
$11,179.60
|
| Rate for Payer: Priority Health Medicare |
$3,244.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,609.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,212.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,308.10
|
| Rate for Payer: UHC Core |
$10,729.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,212.53
|
| Rate for Payer: UHC Exchange |
$3,212.53
|
| Rate for Payer: UHC Medicare Advantage |
$3,212.53
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$3,212.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,637.58
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,352.57 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: BCBS Trust/PPO |
$10,489.54
|
| Rate for Payer: BCN Commercial |
$9,930.57
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,637.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: Nomi Health Commercial |
$10,537.09
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health HMO/PPO |
$11,179.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,609.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,308.10
|
| Rate for Payer: UHC Core |
$10,729.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,637.58
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.02 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.64
|
| Rate for Payer: BCBS Trust/PPO |
$35.18
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.64
|
| Rate for Payer: Nomi Health Commercial |
$35.34
|
| Rate for Payer: PHP Commercial |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health HMO/PPO |
$37.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.93
|
| Rate for Payer: UHC Core |
$35.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.32
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna Commercial |
$36.64
|
| Rate for Payer: Aetna Medicare |
$11.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.47
|
| Rate for Payer: BCBS Complete |
$17.24
|
| Rate for Payer: BCBS MAPPO |
$10.78
|
| Rate for Payer: BCBS Trust/PPO |
$35.43
|
| Rate for Payer: BCN Commercial |
$33.51
|
| Rate for Payer: BCN Medicare Advantage |
$10.78
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.78
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.64
|
| Rate for Payer: Nomi Health Commercial |
$35.34
|
| Rate for Payer: PACE Senior Care Partners |
$10.24
|
| Rate for Payer: PACE SWMI |
$10.78
|
| Rate for Payer: PHP Commercial |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$10.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health HMO/PPO |
$37.50
|
| Rate for Payer: Priority Health Medicare |
$10.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.93
|
| Rate for Payer: UHC Core |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.78
|
| Rate for Payer: UHC Exchange |
$10.78
|
| Rate for Payer: UHC Medicare Advantage |
$10.78
|
| Rate for Payer: VA VA |
$10.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.32
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$336.95 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: BCBS Trust/PPO |
$423.15
|
| Rate for Payer: BCN Commercial |
$400.60
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: Nomi Health Commercial |
$425.07
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health HMO/PPO |
$450.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.17
|
| Rate for Payer: UHC Core |
$432.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.78
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$123.12 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: Aetna Medicare |
$134.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.99
|
| Rate for Payer: BCBS Complete |
$207.35
|
| Rate for Payer: BCBS MAPPO |
$129.60
|
| Rate for Payer: BCBS Trust/PPO |
$426.16
|
| Rate for Payer: BCN Commercial |
$403.04
|
| Rate for Payer: BCN Medicare Advantage |
$129.60
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.60
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: Nomi Health Commercial |
$425.07
|
| Rate for Payer: PACE Senior Care Partners |
$123.12
|
| Rate for Payer: PACE SWMI |
$129.60
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: PHP Medicare Advantage |
$129.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health HMO/PPO |
$450.99
|
| Rate for Payer: Priority Health Medicare |
$130.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.31
|
| Rate for Payer: Railroad Medicare Medicare |
$129.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.17
|
| Rate for Payer: UHC Core |
$432.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.60
|
| Rate for Payer: UHC Exchange |
$129.60
|
| Rate for Payer: UHC Medicare Advantage |
$129.60
|
| Rate for Payer: VA VA |
$129.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.78
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,208.56 |
| Max. Negotiated Rate |
$8,596.47 |
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: BCBS Trust/PPO |
$7,797.00
|
| Rate for Payer: BCN Commercial |
$7,381.50
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.89
|
| Rate for Payer: Nomi Health Commercial |
$7,832.34
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,208.56
|
| Rate for Payer: Priority Health HMO/PPO |
$8,309.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,399.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,405.43
|
| Rate for Payer: UHC Core |
$7,975.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.72
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,268.51 |
| Max. Negotiated Rate |
$8,596.47 |
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: Aetna Medicare |
$2,483.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,984.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,984.88
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$2,387.91
|
| Rate for Payer: BCBS Trust/PPO |
$7,852.40
|
| Rate for Payer: BCN Commercial |
$7,426.39
|
| Rate for Payer: BCN Medicare Advantage |
$2,387.91
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,387.91
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.72
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,507.30
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,746.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.89
|
| Rate for Payer: Nomi Health Commercial |
$7,832.34
|
| Rate for Payer: PACE Senior Care Partners |
$2,268.51
|
| Rate for Payer: PACE SWMI |
$2,387.91
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,387.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,208.56
|
| Rate for Payer: Priority Health HMO/PPO |
$8,309.92
|
| Rate for Payer: Priority Health Medicare |
$2,411.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,399.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,387.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,405.43
|
| Rate for Payer: UHC Core |
$7,975.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,387.91
|
| Rate for Payer: UHC Exchange |
$2,387.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,387.91
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$2,387.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.72
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.63 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.16
|
| Rate for Payer: BCN Commercial |
$25.71
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: Nomi Health Commercial |
$27.28
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO |
$28.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.28
|
| Rate for Payer: UHC Core |
$27.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.95
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.90 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: Aetna Medicare |
$8.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.40
|
| Rate for Payer: BCBS Complete |
$13.31
|
| Rate for Payer: BCBS MAPPO |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.35
|
| Rate for Payer: BCN Commercial |
$25.87
|
| Rate for Payer: BCN Medicare Advantage |
$8.32
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: Nomi Health Commercial |
$27.28
|
| Rate for Payer: PACE Senior Care Partners |
$7.90
|
| Rate for Payer: PACE SWMI |
$8.32
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: PHP Medicare Advantage |
$8.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health HMO/PPO |
$28.94
|
| Rate for Payer: Priority Health Medicare |
$8.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.29
|
| Rate for Payer: Railroad Medicare Medicare |
$8.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.28
|
| Rate for Payer: UHC Core |
$27.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.32
|
| Rate for Payer: UHC Exchange |
$8.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: VA VA |
$8.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.95
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.37 |
| Max. Negotiated Rate |
$27.94 |
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Medicare |
$8.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.70
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$7.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.52
|
| Rate for Payer: BCN Commercial |
$24.13
|
| Rate for Payer: BCN Medicare Advantage |
$7.76
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.76
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Mclaren Medicaid |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.15
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: PACE Senior Care Partners |
$7.37
|
| Rate for Payer: PACE SWMI |
$7.76
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: PHP Medicare Advantage |
$7.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health HMO/PPO |
$27.00
|
| Rate for Payer: Priority Health Medicare |
$7.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.80
|
| Rate for Payer: Railroad Medicare Medicare |
$7.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.32
|
| Rate for Payer: UHC Core |
$25.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.76
|
| Rate for Payer: UHC Exchange |
$7.76
|
| Rate for Payer: UHC Medicare Advantage |
$7.76
|
| Rate for Payer: UHCCP Medicaid |
$13.72
|
| Rate for Payer: VA VA |
$7.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.18 |
| Max. Negotiated Rate |
$27.94 |
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: BCBS Trust/PPO |
$25.34
|
| Rate for Payer: BCN Commercial |
$23.99
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: Nomi Health Commercial |
$25.45
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health HMO/PPO |
$27.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.32
|
| Rate for Payer: UHC Core |
$25.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$26.61
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$23.95 |
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna Medicare |
$6.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.32
|
| Rate for Payer: BCBS Complete |
$12.34
|
| Rate for Payer: BCBS MAPPO |
$6.65
|
| Rate for Payer: BCBS Trust/PPO |
$21.88
|
| Rate for Payer: BCN Commercial |
$20.69
|
| Rate for Payer: BCN Medicare Advantage |
$6.65
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.65
|
| Rate for Payer: Healthscope Commercial |
$23.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.96
|
| Rate for Payer: Mclaren Medicaid |
$11.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.99
|
| Rate for Payer: Meridian Medicaid |
$12.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.62
|
| Rate for Payer: Nomi Health Commercial |
$21.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.32
|
| Rate for Payer: PACE SWMI |
$6.65
|
| Rate for Payer: PHP Commercial |
$22.62
|
| Rate for Payer: PHP Medicare Advantage |
$6.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.30
|
| Rate for Payer: Priority Health HMO/PPO |
$23.15
|
| Rate for Payer: Priority Health Medicare |
$6.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.83
|
| Rate for Payer: Railroad Medicare Medicare |
$6.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.42
|
| Rate for Payer: UHC Core |
$22.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.65
|
| Rate for Payer: UHC Exchange |
$6.65
|
| Rate for Payer: UHC Medicare Advantage |
$6.65
|
| Rate for Payer: UHCCP Medicaid |
$11.76
|
| Rate for Payer: VA VA |
$6.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.96
|
|
