|
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
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
OP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,602.75 |
| Max. Negotiated Rate |
$18,391.82 |
| Rate for Payer: Aetna Commercial |
$17,370.06
|
| Rate for Payer: Aetna Medicare |
$5,313.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,386.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,386.05
|
| Rate for Payer: BCBS Complete |
$3,782.59
|
| Rate for Payer: BCBS MAPPO |
$5,108.84
|
| Rate for Payer: BCBS Trust/PPO |
$16,799.91
|
| Rate for Payer: BCN Commercial |
$16,799.91
|
| Rate for Payer: BCN Medicare Advantage |
$5,108.84
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Commercial |
$17,574.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,108.84
|
| Rate for Payer: Healthscope Commercial |
$18,391.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,326.52
|
| Rate for Payer: Mclaren Medicaid |
$3,602.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,364.28
|
| Rate for Payer: Meridian Medicaid |
$3,782.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,875.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,619.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Nomi Health Commercial |
$16,757.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: PACE Senior Care Partners |
$4,853.40
|
| Rate for Payer: PACE SWMI |
$5,108.84
|
| Rate for Payer: PHP Commercial |
$17,370.06
|
| Rate for Payer: PHP Medicare Advantage |
$5,108.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,602.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,778.76
|
| Rate for Payer: Priority Health Medicare |
$5,159.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,223.01
|
| Rate for Payer: Railroad Medicare Medicare |
$5,108.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,983.12
|
| Rate for Payer: UHC Core |
$17,063.53
|
| Rate for Payer: UHC Exchange |
$5,108.84
|
| Rate for Payer: UHC Medicaid |
$3,602.75
|
| Rate for Payer: UHC Medicare Advantage |
$5,108.84
|
| Rate for Payer: UHCCP Medicaid |
$3,602.75
|
| Rate for Payer: VA VA |
$5,108.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,326.52
|
|
|
HC IR ATHERECSTENT TIB PERO UNI
|
Facility
|
IP
|
$20,435.36
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,223.01 |
| Max. Negotiated Rate |
$18,391.82 |
| Rate for Payer: Aetna Commercial |
$17,370.06
|
| Rate for Payer: BCBS Trust/PPO |
$16,877.56
|
| Rate for Payer: BCN Commercial |
$16,877.56
|
| Rate for Payer: Cash Price |
$16,348.29
|
| Rate for Payer: Cofinity Commercial |
$17,574.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,348.29
|
| Rate for Payer: Healthscope Commercial |
$18,391.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,326.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,370.06
|
| Rate for Payer: Nomi Health Commercial |
$16,757.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,326.52
|
| Rate for Payer: PHP Commercial |
$17,370.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,778.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,223.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,983.12
|
| Rate for Payer: UHC Core |
$17,063.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,326.52
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
IP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,308.15 |
| Max. Negotiated Rate |
$15,915.71 |
| Rate for Payer: Aetna Commercial |
$15,031.50
|
| Rate for Payer: BCBS Trust/PPO |
$14,605.31
|
| Rate for Payer: BCN Commercial |
$14,605.31
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Commercial |
$15,208.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Healthscope Commercial |
$15,915.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,263.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Nomi Health Commercial |
$14,500.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: PHP Commercial |
$15,031.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,385.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,308.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,562.03
|
| Rate for Payer: UHC Core |
$14,766.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,263.09
|
|
|
HC IR ATHERECTOMY FEMPOP UNI
|
Facility
|
OP
|
$17,684.12
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
36100169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,117.71 |
| Max. Negotiated Rate |
$15,915.71 |
| Rate for Payer: Aetna Commercial |
$15,031.50
|
| Rate for Payer: Aetna Medicare |
$4,597.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,526.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,526.29
|
| Rate for Payer: BCBS Complete |
$3,273.33
|
| Rate for Payer: BCBS MAPPO |
$4,421.03
|
| Rate for Payer: BCBS Trust/PPO |
$14,538.12
|
| Rate for Payer: BCN Commercial |
$14,538.12
|
| Rate for Payer: BCN Medicare Advantage |
$4,421.03
|
| Rate for Payer: Cash Price |
$14,147.30
|
| Rate for Payer: Cofinity Commercial |
$15,208.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,147.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,421.03
|
| Rate for Payer: Healthscope Commercial |
$15,915.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,263.09
|
| Rate for Payer: Mclaren Medicaid |
$3,117.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,642.08
|
| Rate for Payer: Meridian Medicaid |
$3,273.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,084.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,863.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,031.50
|
| Rate for Payer: Nomi Health Commercial |
$14,500.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,263.09
|
| Rate for Payer: PACE Senior Care Partners |
$4,199.98
|
| Rate for Payer: PACE SWMI |
$4,421.03
|
| Rate for Payer: PHP Commercial |
$15,031.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,421.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,117.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,385.18
|
| Rate for Payer: Priority Health Medicare |
$4,465.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,308.15
|
| Rate for Payer: Railroad Medicare Medicare |
$4,421.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,562.03
|
| Rate for Payer: UHC Core |
$14,766.24
|
| Rate for Payer: UHC Exchange |
$4,421.03
|
| Rate for Payer: UHC Medicaid |
$3,117.71
|
| Rate for Payer: UHC Medicare Advantage |
$4,421.03
|
| Rate for Payer: UHCCP Medicaid |
$3,117.71
|
| Rate for Payer: VA VA |
$4,421.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,263.09
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,261.12 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: BCBS Trust/PPO |
$16,922.79
|
| Rate for Payer: BCN Commercial |
$16,922.79
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,367.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,826.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,261.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,031.31
|
| Rate for Payer: UHC Core |
$17,109.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,367.59
|
|
|
HC IR ATHERECTOMY STENT FEMPOP UNI
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
36100171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,612.41 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna Medicare |
$5,327.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,403.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,403.16
|
| Rate for Payer: BCBS Complete |
$3,792.72
|
| Rate for Payer: BCBS MAPPO |
$5,122.53
|
| Rate for Payer: BCBS Trust/PPO |
$16,844.93
|
| Rate for Payer: BCN Commercial |
$16,844.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,122.53
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,122.53
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,367.59
|
| Rate for Payer: Mclaren Medicaid |
$3,612.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,378.66
|
| Rate for Payer: Meridian Medicaid |
$3,792.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,890.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,634.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PACE Senior Care Partners |
$4,866.40
|
| Rate for Payer: PACE SWMI |
$5,122.53
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,122.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,612.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,826.40
|
| Rate for Payer: Priority Health Medicare |
$5,173.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,261.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5,122.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,031.31
|
| Rate for Payer: UHC Core |
$17,109.25
|
| Rate for Payer: UHC Exchange |
$5,122.53
|
| Rate for Payer: UHC Medicaid |
$3,612.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,122.53
|
| Rate for Payer: UHCCP Medicaid |
$3,612.41
|
| Rate for Payer: VA VA |
$5,122.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,367.59
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
IP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,589.54 |
| Max. Negotiated Rate |
$20,158.89 |
| Rate for Payer: Aetna Commercial |
$19,038.95
|
| Rate for Payer: BCBS Trust/PPO |
$18,499.14
|
| Rate for Payer: BCN Commercial |
$18,499.14
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Commercial |
$19,262.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Healthscope Commercial |
$20,158.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,799.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Nomi Health Commercial |
$18,366.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: PHP Commercial |
$19,038.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,486.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,589.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,710.92
|
| Rate for Payer: UHC Core |
$18,702.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,799.08
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI
|
Facility
|
OP
|
$22,398.77
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
36100173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,948.90 |
| Max. Negotiated Rate |
$20,158.89 |
| Rate for Payer: Aetna Commercial |
$19,038.95
|
| Rate for Payer: Aetna Medicare |
$5,823.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,999.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,999.62
|
| Rate for Payer: BCBS Complete |
$4,146.01
|
| Rate for Payer: BCBS MAPPO |
$5,599.69
|
| Rate for Payer: BCBS Trust/PPO |
$18,414.03
|
| Rate for Payer: BCN Commercial |
$18,414.03
|
| Rate for Payer: BCN Medicare Advantage |
$5,599.69
|
| Rate for Payer: Cash Price |
$17,919.02
|
| Rate for Payer: Cofinity Commercial |
$19,262.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,919.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,599.69
|
| Rate for Payer: Healthscope Commercial |
$20,158.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,799.08
|
| Rate for Payer: Mclaren Medicaid |
$3,948.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,879.68
|
| Rate for Payer: Meridian Medicaid |
$4,146.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,439.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,159.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,038.95
|
| Rate for Payer: Nomi Health Commercial |
$18,366.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,799.08
|
| Rate for Payer: PACE Senior Care Partners |
$5,319.71
|
| Rate for Payer: PACE SWMI |
$5,599.69
|
| Rate for Payer: PHP Commercial |
$19,038.95
|
| Rate for Payer: PHP Medicare Advantage |
$5,599.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,948.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,486.93
|
| Rate for Payer: Priority Health Medicare |
$5,655.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,589.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5,599.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,710.92
|
| Rate for Payer: UHC Core |
$18,702.97
|
| Rate for Payer: UHC Exchange |
$5,599.69
|
| Rate for Payer: UHC Medicaid |
$3,948.90
|
| Rate for Payer: UHC Medicare Advantage |
$5,599.69
|
| Rate for Payer: UHCCP Medicaid |
$3,948.90
|
| Rate for Payer: VA VA |
$5,599.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,799.08
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,711.17 |
| Max. Negotiated Rate |
$8,735.42 |
| Rate for Payer: Aetna Commercial |
$8,250.12
|
| Rate for Payer: Aetna Medicare |
$2,523.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,033.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,033.13
|
| Rate for Payer: BCBS Complete |
$1,796.58
|
| Rate for Payer: BCBS MAPPO |
$2,426.51
|
| Rate for Payer: BCBS Trust/PPO |
$7,979.32
|
| Rate for Payer: BCN Commercial |
$7,979.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,426.51
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Commercial |
$8,347.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,426.51
|
| Rate for Payer: Healthscope Commercial |
$8,735.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,279.52
|
| Rate for Payer: Mclaren Medicaid |
$1,711.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,547.83
|
| Rate for Payer: Meridian Medicaid |
$1,796.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,790.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,669.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Nomi Health Commercial |
$7,958.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: PACE Senior Care Partners |
$2,305.18
|
| Rate for Payer: PACE SWMI |
$2,426.51
|
| Rate for Payer: PHP Commercial |
$8,250.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,426.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,711.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,444.24
|
| Rate for Payer: Priority Health Medicare |
$2,450.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,755.39
|
| Rate for Payer: Railroad Medicare Medicare |
$2,426.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,541.30
|
| Rate for Payer: UHC Core |
$8,104.53
|
| Rate for Payer: UHC Exchange |
$2,426.51
|
| Rate for Payer: UHC Medicaid |
$1,711.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,426.51
|
| Rate for Payer: UHCCP Medicaid |
$1,711.17
|
| Rate for Payer: VA VA |
$2,426.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,279.52
|
|
|
HC IR ATHERECTOMY TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$9,706.02
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
36100177
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,755.39 |
| Max. Negotiated Rate |
$8,735.42 |
| Rate for Payer: Aetna Commercial |
$8,250.12
|
| Rate for Payer: BCBS Trust/PPO |
$8,016.20
|
| Rate for Payer: BCN Commercial |
$8,016.20
|
| Rate for Payer: Cash Price |
$7,764.82
|
| Rate for Payer: Cofinity Commercial |
$8,347.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,764.82
|
| Rate for Payer: Healthscope Commercial |
$8,735.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,279.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,250.12
|
| Rate for Payer: Nomi Health Commercial |
$7,958.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,279.52
|
| Rate for Payer: PHP Commercial |
$8,250.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,444.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,755.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,541.30
|
| Rate for Payer: UHC Core |
$8,104.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,279.52
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,261.12 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: BCBS Trust/PPO |
$16,922.79
|
| Rate for Payer: BCN Commercial |
$16,922.79
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,367.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,826.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,261.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,031.31
|
| Rate for Payer: UHC Core |
$17,109.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,367.59
|
|
|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
OP
|
$20,490.12
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,612.41 |
| Max. Negotiated Rate |
$18,441.11 |
| Rate for Payer: Aetna Commercial |
$17,416.60
|
| Rate for Payer: Aetna Medicare |
$5,327.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,403.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,403.16
|
| Rate for Payer: BCBS Complete |
$3,792.72
|
| Rate for Payer: BCBS MAPPO |
$5,122.53
|
| Rate for Payer: BCBS Trust/PPO |
$16,844.93
|
| Rate for Payer: BCN Commercial |
$16,844.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,122.53
|
| Rate for Payer: Cash Price |
$16,392.10
|
| Rate for Payer: Cofinity Commercial |
$17,621.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,392.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,122.53
|
| Rate for Payer: Healthscope Commercial |
$18,441.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,367.59
|
| Rate for Payer: Mclaren Medicaid |
$3,612.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,378.66
|
| Rate for Payer: Meridian Medicaid |
$3,792.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,890.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,634.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,416.60
|
| Rate for Payer: Nomi Health Commercial |
$16,801.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,367.59
|
| Rate for Payer: PACE Senior Care Partners |
$4,866.40
|
| Rate for Payer: PACE SWMI |
$5,122.53
|
| Rate for Payer: PHP Commercial |
$17,416.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,122.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,612.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,826.40
|
| Rate for Payer: Priority Health Medicare |
$5,173.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,261.12
|
| Rate for Payer: Railroad Medicare Medicare |
$5,122.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,031.31
|
| Rate for Payer: UHC Core |
$17,109.25
|
| Rate for Payer: UHC Exchange |
$5,122.53
|
| Rate for Payer: UHC Medicaid |
$3,612.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,122.53
|
| Rate for Payer: UHCCP Medicaid |
$3,612.41
|
| Rate for Payer: VA VA |
$5,122.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,367.59
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.69
|
| Rate for Payer: BCN Commercial |
$37.69
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$45.63
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna Medicare |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.26
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS MAPPO |
$11.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.51
|
| Rate for Payer: BCN Commercial |
$37.51
|
| Rate for Payer: BCN Medicare Advantage |
$11.41
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Mclaren Medicaid |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$8.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PACE Senior Care Partners |
$10.84
|
| Rate for Payer: PACE SWMI |
$11.41
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: PHP Medicare Advantage |
$11.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: UHC Exchange |
$11.41
|
| Rate for Payer: UHC Medicaid |
$8.04
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
| Rate for Payer: UHCCP Medicaid |
$8.04
|
| Rate for Payer: VA VA |
$11.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.18 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: BCBS Trust/PPO |
$197.20
|
| Rate for Payer: BCN Commercial |
$197.20
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$238.77
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.10 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna Medicare |
$62.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.62
|
| Rate for Payer: BCBS Complete |
$44.20
|
| Rate for Payer: BCBS MAPPO |
$59.69
|
| Rate for Payer: BCBS Trust/PPO |
$196.29
|
| Rate for Payer: BCN Commercial |
$196.29
|
| Rate for Payer: BCN Medicare Advantage |
$59.69
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.69
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Mclaren Medicaid |
$42.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.68
|
| Rate for Payer: Meridian Medicaid |
$44.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PACE Senior Care Partners |
$56.71
|
| Rate for Payer: PACE SWMI |
$59.69
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: PHP Medicare Advantage |
$59.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Medicare |
$60.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: Railroad Medicare Medicare |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: UHC Exchange |
$59.69
|
| Rate for Payer: UHC Medicaid |
$42.10
|
| Rate for Payer: UHC Medicare Advantage |
$59.69
|
| Rate for Payer: UHCCP Medicaid |
$42.10
|
| Rate for Payer: VA VA |
$59.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: Aetna Medicare |
$147.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.12
|
| Rate for Payer: BCBS Complete |
$104.91
|
| Rate for Payer: BCBS MAPPO |
$141.69
|
| Rate for Payer: BCBS Trust/PPO |
$465.94
|
| Rate for Payer: BCN Commercial |
$465.94
|
| Rate for Payer: BCN Medicare Advantage |
$141.69
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.69
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.08
|
| Rate for Payer: Mclaren Medicaid |
$99.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.78
|
| Rate for Payer: Meridian Medicaid |
$104.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PACE Senior Care Partners |
$134.61
|
| Rate for Payer: PACE SWMI |
$141.69
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: PHP Medicare Advantage |
$141.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.09
|
| Rate for Payer: Priority Health Medicare |
$143.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.47
|
| Rate for Payer: Railroad Medicare Medicare |
$141.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.76
|
| Rate for Payer: UHC Core |
$473.25
|
| Rate for Payer: UHC Exchange |
$141.69
|
| Rate for Payer: UHC Medicaid |
$99.92
|
| Rate for Payer: UHC Medicare Advantage |
$141.69
|
| Rate for Payer: UHCCP Medicaid |
$99.92
|
| Rate for Payer: VA VA |
$141.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.08
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$566.77
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$394.47 |
| Max. Negotiated Rate |
$510.09 |
| Rate for Payer: Aetna Commercial |
$481.75
|
| Rate for Payer: BCBS Trust/PPO |
$468.10
|
| Rate for Payer: BCN Commercial |
$468.10
|
| Rate for Payer: Cash Price |
$453.42
|
| Rate for Payer: Cofinity Commercial |
$487.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.42
|
| Rate for Payer: Healthscope Commercial |
$510.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.75
|
| Rate for Payer: Nomi Health Commercial |
$464.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.08
|
| Rate for Payer: PHP Commercial |
$481.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.76
|
| Rate for Payer: UHC Core |
$473.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.08
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$640.32 |
| Max. Negotiated Rate |
$3,268.79 |
| Rate for Payer: Aetna Commercial |
$3,087.19
|
| Rate for Payer: Aetna Medicare |
$944.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,135.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,135.00
|
| Rate for Payer: BCBS Complete |
$672.28
|
| Rate for Payer: BCBS MAPPO |
$908.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,985.86
|
| Rate for Payer: BCN Commercial |
$2,985.86
|
| Rate for Payer: BCN Medicare Advantage |
$908.00
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Commercial |
$3,123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$908.00
|
| Rate for Payer: Healthscope Commercial |
$3,268.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,723.99
|
| Rate for Payer: Mclaren Medicaid |
$640.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$953.40
|
| Rate for Payer: Meridian Medicaid |
$672.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,044.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$998.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Nomi Health Commercial |
$2,978.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: PACE Senior Care Partners |
$862.60
|
| Rate for Payer: PACE SWMI |
$908.00
|
| Rate for Payer: PHP Commercial |
$3,087.19
|
| Rate for Payer: PHP Medicare Advantage |
$908.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$640.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,159.83
|
| Rate for Payer: Priority Health Medicare |
$917.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,527.87
|
| Rate for Payer: Railroad Medicare Medicare |
$908.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,196.15
|
| Rate for Payer: UHC Core |
$3,032.71
|
| Rate for Payer: UHC Exchange |
$908.00
|
| Rate for Payer: UHC Medicaid |
$640.32
|
| Rate for Payer: UHC Medicare Advantage |
$908.00
|
| Rate for Payer: UHCCP Medicaid |
$640.32
|
| Rate for Payer: VA VA |
$908.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,723.99
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,631.99
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,527.87 |
| Max. Negotiated Rate |
$3,268.79 |
| Rate for Payer: Aetna Commercial |
$3,087.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,999.66
|
| Rate for Payer: BCN Commercial |
$2,999.66
|
| Rate for Payer: Cash Price |
$2,905.59
|
| Rate for Payer: Cofinity Commercial |
$3,123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.59
|
| Rate for Payer: Healthscope Commercial |
$3,268.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,723.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,087.19
|
| Rate for Payer: Nomi Health Commercial |
$2,978.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,723.99
|
| Rate for Payer: PHP Commercial |
$3,087.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,159.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,527.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,196.15
|
| Rate for Payer: UHC Core |
$3,032.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,723.99
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,816.07 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$2,217.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,155.02
|
| Rate for Payer: BCN Commercial |
$2,155.02
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Commercial |
$2,244.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Healthscope Commercial |
$2,348.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,956.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Nomi Health Commercial |
$2,139.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: PHP Commercial |
$2,217.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,270.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,816.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,296.18
|
| Rate for Payer: UHC Core |
$2,178.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,956.97
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,609.30
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$460.02 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$2,217.91
|
| Rate for Payer: Aetna Medicare |
$678.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$815.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$815.41
|
| Rate for Payer: BCBS Complete |
$482.98
|
| Rate for Payer: BCBS MAPPO |
$652.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.11
|
| Rate for Payer: BCN Commercial |
$2,145.11
|
| Rate for Payer: BCN Medicare Advantage |
$652.33
|
| Rate for Payer: Cash Price |
$2,087.44
|
| Rate for Payer: Cofinity Commercial |
$2,244.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$652.33
|
| Rate for Payer: Healthscope Commercial |
$2,348.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,956.97
|
| Rate for Payer: Mclaren Medicaid |
$460.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.94
|
| Rate for Payer: Meridian Medicaid |
$482.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$750.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$717.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,217.91
|
| Rate for Payer: Nomi Health Commercial |
$2,139.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,956.97
|
| Rate for Payer: PACE Senior Care Partners |
$619.71
|
| Rate for Payer: PACE SWMI |
$652.33
|
| Rate for Payer: PHP Commercial |
$2,217.91
|
| Rate for Payer: PHP Medicare Advantage |
$652.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,270.09
|
| Rate for Payer: Priority Health Medicare |
$658.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,816.07
|
| Rate for Payer: Railroad Medicare Medicare |
$652.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,296.18
|
| Rate for Payer: UHC Core |
$2,178.77
|
| Rate for Payer: UHC Exchange |
$652.33
|
| Rate for Payer: UHC Medicaid |
$460.02
|
| Rate for Payer: UHC Medicare Advantage |
$652.33
|
| Rate for Payer: UHCCP Medicaid |
$460.02
|
| Rate for Payer: VA VA |
$652.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,956.97
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,079.38 |
| Max. Negotiated Rate |
$2,688.85 |
| Rate for Payer: Aetna Commercial |
$2,539.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,467.47
|
| Rate for Payer: BCN Commercial |
$2,467.47
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Commercial |
$2,569.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Healthscope Commercial |
$2,688.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,240.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Nomi Health Commercial |
$2,449.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: PHP Commercial |
$2,539.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,599.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,079.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,629.10
|
| Rate for Payer: UHC Core |
$2,494.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,240.71
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,987.61
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$526.72 |
| Max. Negotiated Rate |
$2,688.85 |
| Rate for Payer: Aetna Commercial |
$2,539.47
|
| Rate for Payer: Aetna Medicare |
$776.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$933.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$933.63
|
| Rate for Payer: BCBS Complete |
$553.01
|
| Rate for Payer: BCBS MAPPO |
$746.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,456.11
|
| Rate for Payer: BCN Commercial |
$2,456.11
|
| Rate for Payer: BCN Medicare Advantage |
$746.90
|
| Rate for Payer: Cash Price |
$2,390.09
|
| Rate for Payer: Cofinity Commercial |
$2,569.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,390.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.90
|
| Rate for Payer: Healthscope Commercial |
$2,688.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,240.71
|
| Rate for Payer: Mclaren Medicaid |
$526.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.25
|
| Rate for Payer: Meridian Medicaid |
$553.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,539.47
|
| Rate for Payer: Nomi Health Commercial |
$2,449.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,240.71
|
| Rate for Payer: PACE Senior Care Partners |
$709.56
|
| Rate for Payer: PACE SWMI |
$746.90
|
| Rate for Payer: PHP Commercial |
$2,539.47
|
| Rate for Payer: PHP Medicare Advantage |
$746.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,599.22
|
| Rate for Payer: Priority Health Medicare |
$754.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,079.38
|
| Rate for Payer: Railroad Medicare Medicare |
$746.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,629.10
|
| Rate for Payer: UHC Core |
$2,494.65
|
| Rate for Payer: UHC Exchange |
$746.90
|
| Rate for Payer: UHC Medicaid |
$526.72
|
| Rate for Payer: UHC Medicare Advantage |
$746.90
|
| Rate for Payer: UHCCP Medicaid |
$526.72
|
| Rate for Payer: VA VA |
$746.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,240.71
|
|
