|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$629.31 |
| Max. Negotiated Rate |
$3,212.57 |
| Rate for Payer: Aetna Commercial |
$3,034.09
|
| Rate for Payer: Aetna Medicare |
$928.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,115.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,115.47
|
| Rate for Payer: BCBS Complete |
$660.72
|
| Rate for Payer: BCBS MAPPO |
$892.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,934.50
|
| Rate for Payer: BCN Commercial |
$2,934.50
|
| Rate for Payer: BCN Medicare Advantage |
$892.38
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,069.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.38
|
| Rate for Payer: Healthscope Commercial |
$3,212.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.14
|
| Rate for Payer: Mclaren Medicaid |
$629.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.00
|
| Rate for Payer: Meridian Medicaid |
$660.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$981.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: PACE Senior Care Partners |
$847.76
|
| Rate for Payer: PACE SWMI |
$892.38
|
| Rate for Payer: PHP Commercial |
$3,034.09
|
| Rate for Payer: PHP Medicare Advantage |
$892.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,105.48
|
| Rate for Payer: Priority Health Medicare |
$901.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,484.39
|
| Rate for Payer: Railroad Medicare Medicare |
$892.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.18
|
| Rate for Payer: UHC Core |
$2,980.55
|
| Rate for Payer: UHC Exchange |
$892.38
|
| Rate for Payer: UHC Medicaid |
$629.31
|
| Rate for Payer: UHC Medicare Advantage |
$892.38
|
| Rate for Payer: UHCCP Medicaid |
$629.31
|
| Rate for Payer: VA VA |
$892.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.14
|
|
|
HC IR EMBOLIZATION
|
Facility
|
IP
|
$3,569.52
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,484.39 |
| Max. Negotiated Rate |
$3,212.57 |
| Rate for Payer: Aetna Commercial |
$3,034.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,948.07
|
| Rate for Payer: BCN Commercial |
$2,948.07
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Commercial |
$3,069.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,212.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$2,927.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: PHP Commercial |
$3,034.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,105.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,484.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.18
|
| Rate for Payer: UHC Core |
$2,980.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.14
|
|
|
HC IR ERCP
|
Facility
|
OP
|
$832.99
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$146.86 |
| Max. Negotiated Rate |
$749.69 |
| Rate for Payer: Aetna Commercial |
$708.04
|
| Rate for Payer: Aetna Medicare |
$216.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.31
|
| Rate for Payer: BCBS Complete |
$154.19
|
| Rate for Payer: BCBS MAPPO |
$208.25
|
| Rate for Payer: BCBS Trust/PPO |
$684.80
|
| Rate for Payer: BCN Commercial |
$684.80
|
| Rate for Payer: BCN Medicare Advantage |
$208.25
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$716.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.25
|
| Rate for Payer: Healthscope Commercial |
$749.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.74
|
| Rate for Payer: Mclaren Medicaid |
$146.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.66
|
| Rate for Payer: Meridian Medicaid |
$154.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: PACE Senior Care Partners |
$197.84
|
| Rate for Payer: PACE SWMI |
$208.25
|
| Rate for Payer: PHP Commercial |
$708.04
|
| Rate for Payer: PHP Medicare Advantage |
$208.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.70
|
| Rate for Payer: Priority Health Medicare |
$210.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.76
|
| Rate for Payer: Railroad Medicare Medicare |
$208.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.03
|
| Rate for Payer: UHC Core |
$695.55
|
| Rate for Payer: UHC Exchange |
$208.25
|
| Rate for Payer: UHC Medicaid |
$146.86
|
| Rate for Payer: UHC Medicare Advantage |
$208.25
|
| Rate for Payer: UHCCP Medicaid |
$146.86
|
| Rate for Payer: VA VA |
$208.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.74
|
|
|
HC IR ERCP
|
Facility
|
IP
|
$832.99
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$579.76 |
| Max. Negotiated Rate |
$749.69 |
| Rate for Payer: Aetna Commercial |
$708.04
|
| Rate for Payer: BCBS Trust/PPO |
$687.97
|
| Rate for Payer: BCN Commercial |
$687.97
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$716.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Healthscope Commercial |
$749.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: PHP Commercial |
$708.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.03
|
| Rate for Payer: UHC Core |
$695.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.74
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
IP
|
$641.52
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$446.50 |
| Max. Negotiated Rate |
$577.37 |
| Rate for Payer: Aetna Commercial |
$545.29
|
| Rate for Payer: BCBS Trust/PPO |
$529.83
|
| Rate for Payer: BCN Commercial |
$529.83
|
| Rate for Payer: Cash Price |
$513.22
|
| Rate for Payer: Cofinity Commercial |
$551.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.22
|
| Rate for Payer: Healthscope Commercial |
$577.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$481.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.29
|
| Rate for Payer: Nomi Health Commercial |
$526.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$481.14
|
| Rate for Payer: PHP Commercial |
$545.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$558.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.54
|
| Rate for Payer: UHC Core |
$535.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$481.14
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
OP
|
$641.52
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$577.37 |
| Rate for Payer: Aetna Commercial |
$545.29
|
| Rate for Payer: Aetna Medicare |
$166.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.47
|
| Rate for Payer: BCBS Complete |
$118.75
|
| Rate for Payer: BCBS MAPPO |
$160.38
|
| Rate for Payer: BCBS Trust/PPO |
$527.39
|
| Rate for Payer: BCN Commercial |
$527.39
|
| Rate for Payer: BCN Medicare Advantage |
$160.38
|
| Rate for Payer: Cash Price |
$513.22
|
| Rate for Payer: Cofinity Commercial |
$551.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.38
|
| Rate for Payer: Healthscope Commercial |
$577.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$481.14
|
| Rate for Payer: Mclaren Medicaid |
$113.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.40
|
| Rate for Payer: Meridian Medicaid |
$118.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$545.29
|
| Rate for Payer: Nomi Health Commercial |
$526.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$481.14
|
| Rate for Payer: PACE Senior Care Partners |
$152.36
|
| Rate for Payer: PACE SWMI |
$160.38
|
| Rate for Payer: PHP Commercial |
$545.29
|
| Rate for Payer: PHP Medicare Advantage |
$160.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$558.12
|
| Rate for Payer: Priority Health Medicare |
$161.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.50
|
| Rate for Payer: Railroad Medicare Medicare |
$160.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.54
|
| Rate for Payer: UHC Core |
$535.67
|
| Rate for Payer: UHC Exchange |
$160.38
|
| Rate for Payer: UHC Medicaid |
$113.10
|
| Rate for Payer: UHC Medicare Advantage |
$160.38
|
| Rate for Payer: UHCCP Medicaid |
$113.10
|
| Rate for Payer: VA VA |
$160.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$481.14
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
IP
|
$312.56
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$217.54 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: BCBS Trust/PPO |
$258.14
|
| Rate for Payer: BCN Commercial |
$258.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
OP
|
$312.56
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.10 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Aetna Commercial |
$265.68
|
| Rate for Payer: Aetna Medicare |
$81.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.67
|
| Rate for Payer: BCBS Complete |
$57.85
|
| Rate for Payer: BCBS MAPPO |
$78.14
|
| Rate for Payer: BCBS Trust/PPO |
$256.96
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$78.14
|
| Rate for Payer: Cash Price |
$250.05
|
| Rate for Payer: Cofinity Commercial |
$268.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.14
|
| Rate for Payer: Healthscope Commercial |
$281.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.42
|
| Rate for Payer: Mclaren Medicaid |
$55.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.05
|
| Rate for Payer: Meridian Medicaid |
$57.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.68
|
| Rate for Payer: Nomi Health Commercial |
$256.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.42
|
| Rate for Payer: PACE Senior Care Partners |
$74.23
|
| Rate for Payer: PACE SWMI |
$78.14
|
| Rate for Payer: PHP Commercial |
$265.68
|
| Rate for Payer: PHP Medicare Advantage |
$78.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.93
|
| Rate for Payer: Priority Health Medicare |
$78.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.54
|
| Rate for Payer: Railroad Medicare Medicare |
$78.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.05
|
| Rate for Payer: UHC Core |
$260.99
|
| Rate for Payer: UHC Exchange |
$78.14
|
| Rate for Payer: UHC Medicaid |
$55.10
|
| Rate for Payer: UHC Medicare Advantage |
$78.14
|
| Rate for Payer: UHCCP Medicaid |
$55.10
|
| Rate for Payer: VA VA |
$78.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.42
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$100.99 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.01
|
| Rate for Payer: BCBS Complete |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$143.21
|
| Rate for Payer: BCBS Trust/PPO |
$470.92
|
| Rate for Payer: BCN Commercial |
$470.92
|
| Rate for Payer: BCN Medicare Advantage |
$143.21
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.21
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Mclaren Medicaid |
$100.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.37
|
| Rate for Payer: Meridian Medicaid |
$106.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$136.04
|
| Rate for Payer: PACE SWMI |
$143.21
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Medicare |
$144.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: Railroad Medicare Medicare |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: UHC Exchange |
$143.21
|
| Rate for Payer: UHC Medicaid |
$100.99
|
| Rate for Payer: UHC Medicare Advantage |
$143.21
|
| Rate for Payer: UHCCP Medicaid |
$100.99
|
| Rate for Payer: VA VA |
$143.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.68 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: BCBS Trust/PPO |
$473.09
|
| Rate for Payer: BCN Commercial |
$473.09
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$398.68 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: BCBS Trust/PPO |
$473.09
|
| Rate for Payer: BCN Commercial |
$473.09
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$100.99 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.01
|
| Rate for Payer: BCBS Complete |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$143.21
|
| Rate for Payer: BCBS Trust/PPO |
$470.92
|
| Rate for Payer: BCN Commercial |
$470.92
|
| Rate for Payer: BCN Medicare Advantage |
$143.21
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.21
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Mclaren Medicaid |
$100.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.37
|
| Rate for Payer: Meridian Medicaid |
$106.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$136.04
|
| Rate for Payer: PACE SWMI |
$143.21
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Medicare |
$144.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: Railroad Medicare Medicare |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: UHC Exchange |
$143.21
|
| Rate for Payer: UHC Medicaid |
$100.99
|
| Rate for Payer: UHC Medicare Advantage |
$143.21
|
| Rate for Payer: UHCCP Medicaid |
$100.99
|
| Rate for Payer: VA VA |
$143.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$1,492.33
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$263.10 |
| Max. Negotiated Rate |
$1,343.10 |
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: Aetna Medicare |
$258.67
|
| Rate for Payer: Aetna Medicare |
$388.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.90
|
| Rate for Payer: BCBS Complete |
$276.23
|
| Rate for Payer: BCBS Complete |
$184.15
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS MAPPO |
$248.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.84
|
| Rate for Payer: BCBS Trust/PPO |
$817.90
|
| Rate for Payer: BCN Commercial |
$817.90
|
| Rate for Payer: BCN Commercial |
$1,226.84
|
| Rate for Payer: BCN Medicare Advantage |
$248.72
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Mclaren Medicaid |
$175.40
|
| Rate for Payer: Mclaren Medicaid |
$263.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.74
|
| Rate for Payer: Meridian Medicaid |
$276.23
|
| Rate for Payer: Meridian Medicaid |
$184.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PACE Senior Care Partners |
$236.29
|
| Rate for Payer: PACE Senior Care Partners |
$354.43
|
| Rate for Payer: PACE SWMI |
$248.72
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: PHP Medicare Advantage |
$248.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.33
|
| Rate for Payer: Priority Health Medicare |
$251.21
|
| Rate for Payer: Priority Health Medicare |
$376.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.44
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: Railroad Medicare Medicare |
$248.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.50
|
| Rate for Payer: UHC Core |
$830.73
|
| Rate for Payer: UHC Core |
$1,246.10
|
| Rate for Payer: UHC Exchange |
$248.72
|
| Rate for Payer: UHC Exchange |
$373.08
|
| Rate for Payer: UHC Medicaid |
$175.40
|
| Rate for Payer: UHC Medicaid |
$263.10
|
| Rate for Payer: UHC Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Medicare Advantage |
$248.72
|
| Rate for Payer: UHCCP Medicaid |
$263.10
|
| Rate for Payer: UHCCP Medicaid |
$175.40
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: VA VA |
$248.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$1,492.33
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,038.66 |
| Max. Negotiated Rate |
$1,343.10 |
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.52
|
| Rate for Payer: BCBS Trust/PPO |
$821.68
|
| Rate for Payer: BCN Commercial |
$1,232.52
|
| Rate for Payer: BCN Commercial |
$821.68
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.50
|
| Rate for Payer: UHC Core |
$1,246.10
|
| Rate for Payer: UHC Core |
$830.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
IP
|
$1,537.04
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,069.78 |
| Max. Negotiated Rate |
$1,383.34 |
| Rate for Payer: Aetna Commercial |
$1,306.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.44
|
| Rate for Payer: BCN Commercial |
$1,269.44
|
| Rate for Payer: Cash Price |
$1,229.63
|
| Rate for Payer: Cofinity Commercial |
$1,321.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.63
|
| Rate for Payer: Healthscope Commercial |
$1,383.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.48
|
| Rate for Payer: Nomi Health Commercial |
$1,260.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,152.78
|
| Rate for Payer: PHP Commercial |
$1,306.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,337.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.60
|
| Rate for Payer: UHC Core |
$1,283.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.78
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
OP
|
$1,537.04
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$270.98 |
| Max. Negotiated Rate |
$1,383.34 |
| Rate for Payer: Aetna Commercial |
$1,306.48
|
| Rate for Payer: Aetna Medicare |
$399.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.32
|
| Rate for Payer: BCBS Complete |
$284.51
|
| Rate for Payer: BCBS MAPPO |
$384.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.60
|
| Rate for Payer: BCN Commercial |
$1,263.60
|
| Rate for Payer: BCN Medicare Advantage |
$384.26
|
| Rate for Payer: Cash Price |
$1,229.63
|
| Rate for Payer: Cofinity Commercial |
$1,321.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.26
|
| Rate for Payer: Healthscope Commercial |
$1,383.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.78
|
| Rate for Payer: Mclaren Medicaid |
$270.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.47
|
| Rate for Payer: Meridian Medicaid |
$284.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$422.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.48
|
| Rate for Payer: Nomi Health Commercial |
$1,260.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,152.78
|
| Rate for Payer: PACE Senior Care Partners |
$365.05
|
| Rate for Payer: PACE SWMI |
$384.26
|
| Rate for Payer: PHP Commercial |
$1,306.48
|
| Rate for Payer: PHP Medicare Advantage |
$384.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,337.22
|
| Rate for Payer: Priority Health Medicare |
$388.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.78
|
| Rate for Payer: Railroad Medicare Medicare |
$384.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.60
|
| Rate for Payer: UHC Core |
$1,283.43
|
| Rate for Payer: UHC Exchange |
$384.26
|
| Rate for Payer: UHC Medicaid |
$270.98
|
| Rate for Payer: UHC Medicare Advantage |
$384.26
|
| Rate for Payer: UHCCP Medicaid |
$270.98
|
| Rate for Payer: VA VA |
$384.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.78
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
OP
|
$2,249.70
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.62 |
| Max. Negotiated Rate |
$2,024.73 |
| Rate for Payer: Aetna Commercial |
$1,912.24
|
| Rate for Payer: Aetna Medicare |
$584.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.03
|
| Rate for Payer: BCBS Complete |
$416.42
|
| Rate for Payer: BCBS MAPPO |
$562.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,849.48
|
| Rate for Payer: BCN Commercial |
$1,849.48
|
| Rate for Payer: BCN Medicare Advantage |
$562.42
|
| Rate for Payer: Cash Price |
$1,799.76
|
| Rate for Payer: Cofinity Commercial |
$1,934.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.42
|
| Rate for Payer: Healthscope Commercial |
$2,024.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.28
|
| Rate for Payer: Mclaren Medicaid |
$396.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.55
|
| Rate for Payer: Meridian Medicaid |
$416.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.24
|
| Rate for Payer: Nomi Health Commercial |
$1,844.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.28
|
| Rate for Payer: PACE Senior Care Partners |
$534.30
|
| Rate for Payer: PACE SWMI |
$562.42
|
| Rate for Payer: PHP Commercial |
$1,912.24
|
| Rate for Payer: PHP Medicare Advantage |
$562.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.24
|
| Rate for Payer: Priority Health Medicare |
$568.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.79
|
| Rate for Payer: Railroad Medicare Medicare |
$562.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.74
|
| Rate for Payer: UHC Core |
$1,878.50
|
| Rate for Payer: UHC Exchange |
$562.42
|
| Rate for Payer: UHC Medicaid |
$396.62
|
| Rate for Payer: UHC Medicare Advantage |
$562.42
|
| Rate for Payer: UHCCP Medicaid |
$396.62
|
| Rate for Payer: VA VA |
$562.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.28
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
IP
|
$2,249.70
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,565.79 |
| Max. Negotiated Rate |
$2,024.73 |
| Rate for Payer: Aetna Commercial |
$1,912.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,858.03
|
| Rate for Payer: BCN Commercial |
$1,858.03
|
| Rate for Payer: Cash Price |
$1,799.76
|
| Rate for Payer: Cofinity Commercial |
$1,934.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.76
|
| Rate for Payer: Healthscope Commercial |
$2,024.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.24
|
| Rate for Payer: Nomi Health Commercial |
$1,844.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.28
|
| Rate for Payer: PHP Commercial |
$1,912.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,957.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,565.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.74
|
| Rate for Payer: UHC Core |
$1,878.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.28
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$241.62 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: BCBS Trust/PPO |
$286.71
|
| Rate for Payer: BCN Commercial |
$286.71
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.49
|
| Rate for Payer: UHC Core |
$289.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna Medicare |
$90.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.48
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS MAPPO |
$86.79
|
| Rate for Payer: BCBS Trust/PPO |
$285.39
|
| Rate for Payer: BCN Commercial |
$285.39
|
| Rate for Payer: BCN Medicare Advantage |
$86.79
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.79
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Mclaren Medicaid |
$61.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.13
|
| Rate for Payer: Meridian Medicaid |
$64.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$284.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PACE Senior Care Partners |
$82.45
|
| Rate for Payer: PACE SWMI |
$86.79
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: PHP Medicare Advantage |
$86.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.02
|
| Rate for Payer: Priority Health Medicare |
$87.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.62
|
| Rate for Payer: Railroad Medicare Medicare |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.49
|
| Rate for Payer: UHC Core |
$289.87
|
| Rate for Payer: UHC Exchange |
$86.79
|
| Rate for Payer: UHC Medicaid |
$61.20
|
| Rate for Payer: UHC Medicare Advantage |
$86.79
|
| Rate for Payer: UHCCP Medicaid |
$61.20
|
| Rate for Payer: VA VA |
$86.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
OP
|
$266.57
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$239.91 |
| Rate for Payer: Aetna Commercial |
$226.58
|
| Rate for Payer: Aetna Medicare |
$69.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.30
|
| Rate for Payer: BCBS Complete |
$49.34
|
| Rate for Payer: BCBS MAPPO |
$66.64
|
| Rate for Payer: BCBS Trust/PPO |
$219.15
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$219.15
|
| Rate for Payer: BCN Medicare Advantage |
$66.64
|
| Rate for Payer: Cash Price |
$213.26
|
| Rate for Payer: Cash Price |
$213.26
|
| Rate for Payer: Cofinity Commercial |
$229.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.64
|
| Rate for Payer: Healthscope Commercial |
$239.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.93
|
| Rate for Payer: Mclaren Medicaid |
$47.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.97
|
| Rate for Payer: Meridian Medicaid |
$49.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.58
|
| Rate for Payer: Nomi Health Commercial |
$218.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.93
|
| Rate for Payer: PACE Senior Care Partners |
$63.31
|
| Rate for Payer: PACE SWMI |
$66.64
|
| Rate for Payer: PHP Commercial |
$226.58
|
| Rate for Payer: PHP Medicare Advantage |
$66.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.92
|
| Rate for Payer: Priority Health Medicare |
$67.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.53
|
| Rate for Payer: Railroad Medicare Medicare |
$66.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.58
|
| Rate for Payer: UHC Core |
$222.59
|
| Rate for Payer: UHC Exchange |
$66.64
|
| Rate for Payer: UHC Medicaid |
$47.00
|
| Rate for Payer: UHC Medicare Advantage |
$66.64
|
| Rate for Payer: UHCCP Medicaid |
$47.00
|
| Rate for Payer: VA VA |
$66.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.93
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
IP
|
$266.57
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$185.53 |
| Max. Negotiated Rate |
$239.91 |
| Rate for Payer: Aetna Commercial |
$226.58
|
| Rate for Payer: BCBS Trust/PPO |
$220.16
|
| Rate for Payer: BCN Commercial |
$220.16
|
| Rate for Payer: Cash Price |
$213.26
|
| Rate for Payer: Cofinity Commercial |
$229.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.26
|
| Rate for Payer: Healthscope Commercial |
$239.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.58
|
| Rate for Payer: Nomi Health Commercial |
$218.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.93
|
| Rate for Payer: PHP Commercial |
$226.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$231.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.58
|
| Rate for Payer: UHC Core |
$222.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.93
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
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 GUIDE VISCERAL TISSUE AB
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
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 GUIDEWIRE
|
Facility
|
OP
|
$45.63
|
|
| Hospital Charge Code |
27200306
|
|
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
|
|
