|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
IP
|
$1,205.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$838.68 |
| Max. Negotiated Rate |
$1,084.50 |
| Rate for Payer: Aetna Commercial |
$1,024.25
|
| Rate for Payer: BCBS Trust/PPO |
$995.21
|
| Rate for Payer: BCN Commercial |
$995.21
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$1,036.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.00
|
| Rate for Payer: Healthscope Commercial |
$1,084.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,024.25
|
| Rate for Payer: Nomi Health Commercial |
$988.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PHP Commercial |
$1,024.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,048.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$838.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.40
|
| Rate for Payer: UHC Core |
$1,006.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.75
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
OP
|
$1,205.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$212.44 |
| Max. Negotiated Rate |
$1,084.50 |
| Rate for Payer: Aetna Commercial |
$1,024.25
|
| Rate for Payer: Aetna Medicare |
$313.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.56
|
| Rate for Payer: BCBS Complete |
$223.05
|
| Rate for Payer: BCBS MAPPO |
$301.25
|
| Rate for Payer: BCBS Trust/PPO |
$990.63
|
| Rate for Payer: BCN Commercial |
$990.63
|
| Rate for Payer: BCN Medicare Advantage |
$301.25
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$1,036.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.25
|
| Rate for Payer: Healthscope Commercial |
$1,084.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.75
|
| Rate for Payer: Mclaren Medicaid |
$212.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.31
|
| Rate for Payer: Meridian Medicaid |
$223.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$331.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,024.25
|
| Rate for Payer: Nomi Health Commercial |
$988.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE Senior Care Partners |
$286.19
|
| Rate for Payer: PACE SWMI |
$301.25
|
| Rate for Payer: PHP Commercial |
$1,024.25
|
| Rate for Payer: PHP Medicare Advantage |
$301.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,048.35
|
| Rate for Payer: Priority Health Medicare |
$304.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$838.68
|
| Rate for Payer: Railroad Medicare Medicare |
$301.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.40
|
| Rate for Payer: UHC Core |
$1,006.17
|
| Rate for Payer: UHC Exchange |
$301.25
|
| Rate for Payer: UHC Medicaid |
$212.44
|
| Rate for Payer: UHC Medicare Advantage |
$301.25
|
| Rate for Payer: UHCCP Medicaid |
$212.44
|
| Rate for Payer: VA VA |
$301.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.75
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
OP
|
$141.41
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.93 |
| Max. Negotiated Rate |
$127.27 |
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: Aetna Medicare |
$36.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.19
|
| Rate for Payer: BCBS Complete |
$26.17
|
| Rate for Payer: BCBS MAPPO |
$35.35
|
| Rate for Payer: BCBS Trust/PPO |
$116.25
|
| Rate for Payer: BCN Commercial |
$116.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.35
|
| Rate for Payer: Cash Price |
$113.13
|
| Rate for Payer: Cofinity Commercial |
$121.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.35
|
| Rate for Payer: Healthscope Commercial |
$127.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.06
|
| Rate for Payer: Mclaren Medicaid |
$24.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.12
|
| Rate for Payer: Meridian Medicaid |
$26.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.20
|
| Rate for Payer: Nomi Health Commercial |
$115.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.06
|
| Rate for Payer: PACE Senior Care Partners |
$33.58
|
| Rate for Payer: PACE SWMI |
$35.35
|
| Rate for Payer: PHP Commercial |
$120.20
|
| Rate for Payer: PHP Medicare Advantage |
$35.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.03
|
| Rate for Payer: Priority Health Medicare |
$35.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.42
|
| Rate for Payer: Railroad Medicare Medicare |
$35.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.44
|
| Rate for Payer: UHC Core |
$118.08
|
| Rate for Payer: UHC Exchange |
$35.35
|
| Rate for Payer: UHC Medicaid |
$24.93
|
| Rate for Payer: UHC Medicare Advantage |
$35.35
|
| Rate for Payer: UHCCP Medicaid |
$24.93
|
| Rate for Payer: VA VA |
$35.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.06
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
IP
|
$141.41
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$98.42 |
| Max. Negotiated Rate |
$127.27 |
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: BCBS Trust/PPO |
$116.79
|
| Rate for Payer: BCN Commercial |
$116.79
|
| Rate for Payer: Cash Price |
$113.13
|
| Rate for Payer: Cofinity Commercial |
$121.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.13
|
| Rate for Payer: Healthscope Commercial |
$127.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.20
|
| Rate for Payer: Nomi Health Commercial |
$115.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.06
|
| Rate for Payer: PHP Commercial |
$120.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.44
|
| Rate for Payer: UHC Core |
$118.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.06
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
OP
|
$4.24
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare |
$1.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.32
|
| Rate for Payer: BCBS Complete |
$0.78
|
| Rate for Payer: BCBS MAPPO |
$1.06
|
| Rate for Payer: BCBS Trust/PPO |
$3.49
|
| Rate for Payer: BCN Commercial |
$3.49
|
| Rate for Payer: BCN Medicare Advantage |
$1.06
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.06
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: Mclaren Medicaid |
$0.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.11
|
| Rate for Payer: Meridian Medicaid |
$0.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: PACE Senior Care Partners |
$1.01
|
| Rate for Payer: PACE SWMI |
$1.06
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: PHP Medicare Advantage |
$1.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.69
|
| Rate for Payer: Priority Health Medicare |
$1.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.73
|
| Rate for Payer: UHC Core |
$3.54
|
| Rate for Payer: UHC Exchange |
$1.06
|
| Rate for Payer: UHC Medicaid |
$0.75
|
| Rate for Payer: UHC Medicare Advantage |
$1.06
|
| Rate for Payer: UHCCP Medicaid |
$0.75
|
| Rate for Payer: VA VA |
$1.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
IP
|
$4.24
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: BCBS Trust/PPO |
$3.50
|
| Rate for Payer: BCN Commercial |
$3.50
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.73
|
| Rate for Payer: UHC Core |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
IP
|
$895.68
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$623.39 |
| Max. Negotiated Rate |
$806.11 |
| Rate for Payer: Aetna Commercial |
$761.33
|
| Rate for Payer: BCBS Trust/PPO |
$739.74
|
| Rate for Payer: BCN Commercial |
$739.74
|
| Rate for Payer: Cash Price |
$716.54
|
| Rate for Payer: Cofinity Commercial |
$770.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.54
|
| Rate for Payer: Healthscope Commercial |
$806.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.33
|
| Rate for Payer: Nomi Health Commercial |
$734.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.76
|
| Rate for Payer: PHP Commercial |
$761.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$779.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$623.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$788.20
|
| Rate for Payer: UHC Core |
$747.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.76
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
OP
|
$895.68
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$157.91 |
| Max. Negotiated Rate |
$806.11 |
| Rate for Payer: Aetna Commercial |
$761.33
|
| Rate for Payer: Aetna Medicare |
$232.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$279.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$279.90
|
| Rate for Payer: BCBS Complete |
$165.79
|
| Rate for Payer: BCBS MAPPO |
$223.92
|
| Rate for Payer: BCBS Trust/PPO |
$736.34
|
| Rate for Payer: BCN Commercial |
$736.34
|
| Rate for Payer: BCN Medicare Advantage |
$223.92
|
| Rate for Payer: Cash Price |
$716.54
|
| Rate for Payer: Cofinity Commercial |
$770.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.92
|
| Rate for Payer: Healthscope Commercial |
$806.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.76
|
| Rate for Payer: Mclaren Medicaid |
$157.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.12
|
| Rate for Payer: Meridian Medicaid |
$165.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$257.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$246.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.33
|
| Rate for Payer: Nomi Health Commercial |
$734.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.76
|
| Rate for Payer: PACE Senior Care Partners |
$212.72
|
| Rate for Payer: PACE SWMI |
$223.92
|
| Rate for Payer: PHP Commercial |
$761.33
|
| Rate for Payer: PHP Medicare Advantage |
$223.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$779.24
|
| Rate for Payer: Priority Health Medicare |
$226.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$623.39
|
| Rate for Payer: Railroad Medicare Medicare |
$223.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$788.20
|
| Rate for Payer: UHC Core |
$747.89
|
| Rate for Payer: UHC Exchange |
$223.92
|
| Rate for Payer: UHC Medicaid |
$157.91
|
| Rate for Payer: UHC Medicare Advantage |
$223.92
|
| Rate for Payer: UHCCP Medicaid |
$157.91
|
| Rate for Payer: VA VA |
$223.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.76
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
OP
|
$1,751.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$308.74 |
| Max. Negotiated Rate |
$1,576.08 |
| Rate for Payer: Aetna Commercial |
$1,488.52
|
| Rate for Payer: Aetna Medicare |
$455.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$547.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$547.25
|
| Rate for Payer: BCBS Complete |
$324.15
|
| Rate for Payer: BCBS MAPPO |
$437.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.66
|
| Rate for Payer: BCN Commercial |
$1,439.66
|
| Rate for Payer: BCN Medicare Advantage |
$437.80
|
| Rate for Payer: Cash Price |
$1,400.96
|
| Rate for Payer: Cofinity Commercial |
$1,506.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.80
|
| Rate for Payer: Healthscope Commercial |
$1,576.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.40
|
| Rate for Payer: Mclaren Medicaid |
$308.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.69
|
| Rate for Payer: Meridian Medicaid |
$324.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$503.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$481.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.52
|
| Rate for Payer: Nomi Health Commercial |
$1,435.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.40
|
| Rate for Payer: PACE Senior Care Partners |
$415.91
|
| Rate for Payer: PACE SWMI |
$437.80
|
| Rate for Payer: PHP Commercial |
$1,488.52
|
| Rate for Payer: PHP Medicare Advantage |
$437.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,523.54
|
| Rate for Payer: Priority Health Medicare |
$442.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.84
|
| Rate for Payer: Railroad Medicare Medicare |
$437.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,541.06
|
| Rate for Payer: UHC Core |
$1,462.25
|
| Rate for Payer: UHC Exchange |
$437.80
|
| Rate for Payer: UHC Medicaid |
$308.74
|
| Rate for Payer: UHC Medicare Advantage |
$437.80
|
| Rate for Payer: UHCCP Medicaid |
$308.74
|
| Rate for Payer: VA VA |
$437.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.40
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,751.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,218.84 |
| Max. Negotiated Rate |
$1,576.08 |
| Rate for Payer: Aetna Commercial |
$1,488.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,446.32
|
| Rate for Payer: BCN Commercial |
$1,446.32
|
| Rate for Payer: Cash Price |
$1,400.96
|
| Rate for Payer: Cofinity Commercial |
$1,506.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.96
|
| Rate for Payer: Healthscope Commercial |
$1,576.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.52
|
| Rate for Payer: Nomi Health Commercial |
$1,435.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.40
|
| Rate for Payer: PHP Commercial |
$1,488.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,523.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,541.06
|
| Rate for Payer: UHC Core |
$1,462.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.40
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
OP
|
$3,331.45
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$587.33 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna Medicare |
$866.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,041.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,041.08
|
| Rate for Payer: BCBS Complete |
$616.65
|
| Rate for Payer: BCBS MAPPO |
$832.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,738.79
|
| Rate for Payer: BCN Commercial |
$2,738.79
|
| Rate for Payer: BCN Medicare Advantage |
$832.86
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.86
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Mclaren Medicaid |
$587.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.51
|
| Rate for Payer: Meridian Medicaid |
$616.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$957.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$916.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$2,731.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PACE Senior Care Partners |
$791.22
|
| Rate for Payer: PACE SWMI |
$832.86
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: PHP Medicare Advantage |
$832.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,898.36
|
| Rate for Payer: Priority Health Medicare |
$841.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,318.69
|
| Rate for Payer: Railroad Medicare Medicare |
$832.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,931.68
|
| Rate for Payer: UHC Core |
$2,781.76
|
| Rate for Payer: UHC Exchange |
$832.86
|
| Rate for Payer: UHC Medicaid |
$587.33
|
| Rate for Payer: UHC Medicare Advantage |
$832.86
|
| Rate for Payer: UHCCP Medicaid |
$587.33
|
| Rate for Payer: VA VA |
$832.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
IP
|
$3,331.45
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,318.69 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.44
|
| Rate for Payer: BCN Commercial |
$2,751.44
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$2,731.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,898.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,318.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,931.68
|
| Rate for Payer: UHC Core |
$2,781.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$621.77 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: Aetna Medicare |
$916.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,102.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,102.11
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: BCBS MAPPO |
$881.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.34
|
| Rate for Payer: BCN Commercial |
$2,899.34
|
| Rate for Payer: BCN Medicare Advantage |
$881.69
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.69
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Mclaren Medicaid |
$621.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.77
|
| Rate for Payer: Meridian Medicaid |
$652.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PACE Senior Care Partners |
$837.60
|
| Rate for Payer: PACE SWMI |
$881.69
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Medicare |
$890.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: Railroad Medicare Medicare |
$881.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: UHC Exchange |
$881.69
|
| Rate for Payer: UHC Medicaid |
$621.77
|
| Rate for Payer: UHC Medicare Advantage |
$881.69
|
| Rate for Payer: UHCCP Medicaid |
$621.77
|
| Rate for Payer: VA VA |
$881.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,454.62 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,912.74
|
| Rate for Payer: BCN Commercial |
$2,912.74
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,772.03 |
| Max. Negotiated Rate |
$9,046.10 |
| Rate for Payer: Aetna Commercial |
$8,543.54
|
| Rate for Payer: Aetna Medicare |
$2,613.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,141.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,141.01
|
| Rate for Payer: BCBS Complete |
$1,860.48
|
| Rate for Payer: BCBS MAPPO |
$2,512.80
|
| Rate for Payer: BCBS Trust/PPO |
$8,263.11
|
| Rate for Payer: BCN Commercial |
$8,263.11
|
| Rate for Payer: BCN Medicare Advantage |
$2,512.80
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Commercial |
$8,644.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,512.80
|
| Rate for Payer: Healthscope Commercial |
$9,046.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.41
|
| Rate for Payer: Mclaren Medicaid |
$1,772.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,638.45
|
| Rate for Payer: Meridian Medicaid |
$1,860.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,889.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,764.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Nomi Health Commercial |
$8,242.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: PACE Senior Care Partners |
$2,387.16
|
| Rate for Payer: PACE SWMI |
$2,512.80
|
| Rate for Payer: PHP Commercial |
$8,543.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,512.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,772.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,744.56
|
| Rate for Payer: Priority Health Medicare |
$2,537.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,995.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,512.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,845.07
|
| Rate for Payer: UHC Core |
$8,392.77
|
| Rate for Payer: UHC Exchange |
$2,512.80
|
| Rate for Payer: UHC Medicaid |
$1,772.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,512.80
|
| Rate for Payer: UHCCP Medicaid |
$1,772.03
|
| Rate for Payer: VA VA |
$2,512.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.41
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,995.65 |
| Max. Negotiated Rate |
$9,046.10 |
| Rate for Payer: Aetna Commercial |
$8,543.54
|
| Rate for Payer: BCBS Trust/PPO |
$8,301.30
|
| Rate for Payer: BCN Commercial |
$8,301.30
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Commercial |
$8,644.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Healthscope Commercial |
$9,046.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Nomi Health Commercial |
$8,242.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: PHP Commercial |
$8,543.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,744.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,995.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,845.07
|
| Rate for Payer: UHC Core |
$8,392.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.41
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
IP
|
$3,539.77
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,463.68 |
| Max. Negotiated Rate |
$3,185.79 |
| Rate for Payer: Aetna Commercial |
$3,008.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.50
|
| Rate for Payer: BCN Commercial |
$2,923.50
|
| Rate for Payer: Cash Price |
$2,831.82
|
| Rate for Payer: Cofinity Commercial |
$3,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,831.82
|
| Rate for Payer: Healthscope Commercial |
$3,185.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,654.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,008.80
|
| Rate for Payer: Nomi Health Commercial |
$2,902.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,654.83
|
| Rate for Payer: PHP Commercial |
$3,008.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,079.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,463.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,115.00
|
| Rate for Payer: UHC Core |
$2,955.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,654.83
|
|
|
HC IR AORTAGRAM ABDOMEN
|
Facility
|
OP
|
$3,539.77
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
32000176
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$624.06 |
| Max. Negotiated Rate |
$3,185.79 |
| Rate for Payer: Aetna Commercial |
$3,008.80
|
| Rate for Payer: Aetna Medicare |
$920.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,106.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,106.18
|
| Rate for Payer: BCBS Complete |
$655.21
|
| Rate for Payer: BCBS MAPPO |
$884.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,910.04
|
| Rate for Payer: BCN Commercial |
$2,910.04
|
| Rate for Payer: BCN Medicare Advantage |
$884.94
|
| Rate for Payer: Cash Price |
$2,831.82
|
| Rate for Payer: Cofinity Commercial |
$3,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,831.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.94
|
| Rate for Payer: Healthscope Commercial |
$3,185.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,654.83
|
| Rate for Payer: Mclaren Medicaid |
$624.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$929.19
|
| Rate for Payer: Meridian Medicaid |
$655.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,017.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$973.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,008.80
|
| Rate for Payer: Nomi Health Commercial |
$2,902.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,654.83
|
| Rate for Payer: PACE Senior Care Partners |
$840.70
|
| Rate for Payer: PACE SWMI |
$884.94
|
| Rate for Payer: PHP Commercial |
$3,008.80
|
| Rate for Payer: PHP Medicare Advantage |
$884.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$624.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,079.60
|
| Rate for Payer: Priority Health Medicare |
$893.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,463.68
|
| Rate for Payer: Railroad Medicare Medicare |
$884.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,115.00
|
| Rate for Payer: UHC Core |
$2,955.71
|
| Rate for Payer: UHC Exchange |
$884.94
|
| Rate for Payer: UHC Medicaid |
$624.06
|
| Rate for Payer: UHC Medicare Advantage |
$884.94
|
| Rate for Payer: UHCCP Medicaid |
$624.06
|
| Rate for Payer: VA VA |
$884.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,654.83
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
OP
|
$4,198.39
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$740.18 |
| Max. Negotiated Rate |
$3,778.55 |
| Rate for Payer: Aetna Commercial |
$3,568.63
|
| Rate for Payer: Aetna Medicare |
$1,091.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,312.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,312.00
|
| Rate for Payer: BCBS Complete |
$777.12
|
| Rate for Payer: BCBS MAPPO |
$1,049.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,451.50
|
| Rate for Payer: BCN Commercial |
$3,451.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.60
|
| Rate for Payer: Cash Price |
$3,358.71
|
| Rate for Payer: Cofinity Commercial |
$3,610.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.60
|
| Rate for Payer: Healthscope Commercial |
$3,778.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,148.79
|
| Rate for Payer: Mclaren Medicaid |
$740.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,102.08
|
| Rate for Payer: Meridian Medicaid |
$777.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,207.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,154.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,568.63
|
| Rate for Payer: Nomi Health Commercial |
$3,442.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.79
|
| Rate for Payer: PACE Senior Care Partners |
$997.12
|
| Rate for Payer: PACE SWMI |
$1,049.60
|
| Rate for Payer: PHP Commercial |
$3,568.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$740.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,652.60
|
| Rate for Payer: Priority Health Medicare |
$1,060.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,922.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,049.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,694.58
|
| Rate for Payer: UHC Core |
$3,505.66
|
| Rate for Payer: UHC Exchange |
$1,049.60
|
| Rate for Payer: UHC Medicaid |
$740.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,049.60
|
| Rate for Payer: UHCCP Medicaid |
$740.18
|
| Rate for Payer: VA VA |
$1,049.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,148.79
|
|
|
HC IR AORTAGRAM THORACIC
|
Facility
|
IP
|
$4,198.39
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
32000175
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,922.08 |
| Max. Negotiated Rate |
$3,778.55 |
| Rate for Payer: Aetna Commercial |
$3,568.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,467.45
|
| Rate for Payer: BCN Commercial |
$3,467.45
|
| Rate for Payer: Cash Price |
$3,358.71
|
| Rate for Payer: Cofinity Commercial |
$3,610.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.71
|
| Rate for Payer: Healthscope Commercial |
$3,778.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,148.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,568.63
|
| Rate for Payer: Nomi Health Commercial |
$3,442.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.79
|
| Rate for Payer: PHP Commercial |
$3,568.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,652.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,922.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,694.58
|
| Rate for Payer: UHC Core |
$3,505.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,148.79
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
IP
|
$3,862.58
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,688.36 |
| Max. Negotiated Rate |
$3,476.32 |
| Rate for Payer: Aetna Commercial |
$3,283.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,190.10
|
| Rate for Payer: BCN Commercial |
$3,190.10
|
| Rate for Payer: Cash Price |
$3,090.06
|
| Rate for Payer: Cofinity Commercial |
$3,321.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,090.06
|
| Rate for Payer: Healthscope Commercial |
$3,476.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,896.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,283.19
|
| Rate for Payer: Nomi Health Commercial |
$3,167.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,896.93
|
| Rate for Payer: PHP Commercial |
$3,283.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,360.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,688.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,399.07
|
| Rate for Payer: UHC Core |
$3,225.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,896.93
|
|
|
HC IR ARTERIOGRAM
|
Facility
|
OP
|
$3,862.58
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
32000189
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$680.97 |
| Max. Negotiated Rate |
$3,476.32 |
| Rate for Payer: Aetna Commercial |
$3,283.19
|
| Rate for Payer: Aetna Medicare |
$1,004.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,207.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,207.06
|
| Rate for Payer: BCBS Complete |
$714.96
|
| Rate for Payer: BCBS MAPPO |
$965.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,175.43
|
| Rate for Payer: BCN Commercial |
$3,175.43
|
| Rate for Payer: BCN Medicare Advantage |
$965.64
|
| Rate for Payer: Cash Price |
$3,090.06
|
| Rate for Payer: Cofinity Commercial |
$3,321.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,090.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$965.64
|
| Rate for Payer: Healthscope Commercial |
$3,476.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,896.93
|
| Rate for Payer: Mclaren Medicaid |
$680.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,013.93
|
| Rate for Payer: Meridian Medicaid |
$714.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,110.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,062.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,283.19
|
| Rate for Payer: Nomi Health Commercial |
$3,167.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,896.93
|
| Rate for Payer: PACE Senior Care Partners |
$917.36
|
| Rate for Payer: PACE SWMI |
$965.64
|
| Rate for Payer: PHP Commercial |
$3,283.19
|
| Rate for Payer: PHP Medicare Advantage |
$965.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,360.44
|
| Rate for Payer: Priority Health Medicare |
$975.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,688.36
|
| Rate for Payer: Railroad Medicare Medicare |
$965.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,399.07
|
| Rate for Payer: UHC Core |
$3,225.25
|
| Rate for Payer: UHC Exchange |
$965.64
|
| Rate for Payer: UHC Medicaid |
$680.97
|
| Rate for Payer: UHC Medicare Advantage |
$965.64
|
| Rate for Payer: UHCCP Medicaid |
$680.97
|
| Rate for Payer: VA VA |
$965.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,896.93
|
|
|
HC IR ARTERIOGRAM EXTREMITY BILAT
|
Facility
|
IP
|
$3,237.62
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
32000190
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,253.38 |
| Max. Negotiated Rate |
$2,913.86 |
| Rate for Payer: Aetna Commercial |
$2,751.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,673.95
|
| Rate for Payer: BCN Commercial |
$2,673.95
|
| Rate for Payer: Cash Price |
$2,590.10
|
| Rate for Payer: Cofinity Commercial |
$2,784.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.10
|
| Rate for Payer: Healthscope Commercial |
$2,913.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,428.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,751.98
|
| Rate for Payer: Nomi Health Commercial |
$2,654.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.22
|
| Rate for Payer: PHP Commercial |
$2,751.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,816.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,253.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,849.11
|
| Rate for Payer: UHC Core |
$2,703.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,428.22
|
|
