|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$465.28 |
| Max. Negotiated Rate |
$2,375.24 |
| Rate for Payer: Aetna Commercial |
$2,243.29
|
| Rate for Payer: Aetna Medicare |
$686.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$824.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$824.74
|
| Rate for Payer: BCBS Complete |
$488.51
|
| Rate for Payer: BCBS MAPPO |
$659.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,169.65
|
| Rate for Payer: BCN Commercial |
$2,169.65
|
| Rate for Payer: BCN Medicare Advantage |
$659.79
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Commercial |
$2,269.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.79
|
| Rate for Payer: Healthscope Commercial |
$2,375.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.37
|
| Rate for Payer: Mclaren Medicaid |
$465.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.78
|
| Rate for Payer: Meridian Medicaid |
$488.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$758.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Nomi Health Commercial |
$2,164.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: PACE Senior Care Partners |
$626.80
|
| Rate for Payer: PACE SWMI |
$659.79
|
| Rate for Payer: PHP Commercial |
$2,243.29
|
| Rate for Payer: PHP Medicare Advantage |
$659.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,296.07
|
| Rate for Payer: Priority Health Medicare |
$666.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,836.86
|
| Rate for Payer: Railroad Medicare Medicare |
$659.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,322.46
|
| Rate for Payer: UHC Core |
$2,203.70
|
| Rate for Payer: UHC Exchange |
$659.79
|
| Rate for Payer: UHC Medicaid |
$465.28
|
| Rate for Payer: UHC Medicare Advantage |
$659.79
|
| Rate for Payer: UHCCP Medicaid |
$465.28
|
| Rate for Payer: VA VA |
$659.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.37
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,836.86 |
| Max. Negotiated Rate |
$2,375.24 |
| Rate for Payer: Aetna Commercial |
$2,243.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,179.68
|
| Rate for Payer: BCN Commercial |
$2,179.68
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Commercial |
$2,269.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Healthscope Commercial |
$2,375.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Nomi Health Commercial |
$2,164.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: PHP Commercial |
$2,243.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,296.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,836.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,322.46
|
| Rate for Payer: UHC Core |
$2,203.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.37
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,642.92 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: BCBS Trust/PPO |
$10,256.02
|
| Rate for Payer: BCN Commercial |
$10,256.02
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,803.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,642.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,927.83
|
| Rate for Payer: UHC Core |
$10,369.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,189.29 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna Medicare |
$3,228.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,880.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,880.62
|
| Rate for Payer: BCBS Complete |
$2,298.57
|
| Rate for Payer: BCBS MAPPO |
$3,104.50
|
| Rate for Payer: BCBS Trust/PPO |
$10,208.83
|
| Rate for Payer: BCN Commercial |
$10,208.83
|
| Rate for Payer: BCN Medicare Advantage |
$3,104.50
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,104.50
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Mclaren Medicaid |
$2,189.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,259.72
|
| Rate for Payer: Meridian Medicaid |
$2,298.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,570.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,414.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: PACE Senior Care Partners |
$2,949.27
|
| Rate for Payer: PACE SWMI |
$3,104.50
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,104.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,189.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,803.65
|
| Rate for Payer: Priority Health Medicare |
$3,135.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,642.92
|
| Rate for Payer: Railroad Medicare Medicare |
$3,104.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,927.83
|
| Rate for Payer: UHC Core |
$10,369.02
|
| Rate for Payer: UHC Exchange |
$3,104.50
|
| Rate for Payer: UHC Medicaid |
$2,189.29
|
| Rate for Payer: UHC Medicare Advantage |
$3,104.50
|
| Rate for Payer: UHCCP Medicaid |
$2,189.29
|
| Rate for Payer: VA VA |
$3,104.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.83 |
| Max. Negotiated Rate |
$1,316.22 |
| Rate for Payer: Aetna Commercial |
$1,243.10
|
| Rate for Payer: Aetna Medicare |
$380.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$457.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$457.02
|
| Rate for Payer: BCBS Complete |
$270.70
|
| Rate for Payer: BCBS MAPPO |
$365.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.30
|
| Rate for Payer: BCN Commercial |
$1,202.30
|
| Rate for Payer: BCN Medicare Advantage |
$365.62
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.62
|
| Rate for Payer: Healthscope Commercial |
$1,316.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,096.85
|
| Rate for Payer: Mclaren Medicaid |
$257.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$383.90
|
| Rate for Payer: Meridian Medicaid |
$270.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Nomi Health Commercial |
$1,199.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: PACE Senior Care Partners |
$347.34
|
| Rate for Payer: PACE SWMI |
$365.62
|
| Rate for Payer: PHP Commercial |
$1,243.10
|
| Rate for Payer: PHP Medicare Advantage |
$365.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,272.35
|
| Rate for Payer: Priority Health Medicare |
$369.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,017.88
|
| Rate for Payer: Railroad Medicare Medicare |
$365.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,286.97
|
| Rate for Payer: UHC Core |
$1,221.16
|
| Rate for Payer: UHC Exchange |
$365.62
|
| Rate for Payer: UHC Medicaid |
$257.83
|
| Rate for Payer: UHC Medicare Advantage |
$365.62
|
| Rate for Payer: UHCCP Medicaid |
$257.83
|
| Rate for Payer: VA VA |
$365.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,096.85
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,017.88 |
| Max. Negotiated Rate |
$1,316.22 |
| Rate for Payer: Aetna Commercial |
$1,243.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,207.85
|
| Rate for Payer: BCN Commercial |
$1,207.85
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Healthscope Commercial |
$1,316.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,096.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Nomi Health Commercial |
$1,199.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: PHP Commercial |
$1,243.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,272.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,017.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,286.97
|
| Rate for Payer: UHC Core |
$1,221.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,096.85
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$776.57 |
| Max. Negotiated Rate |
$1,004.18 |
| Rate for Payer: Aetna Commercial |
$948.40
|
| Rate for Payer: BCBS Trust/PPO |
$921.51
|
| Rate for Payer: BCN Commercial |
$921.51
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Commercial |
$959.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Healthscope Commercial |
$1,004.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Nomi Health Commercial |
$914.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: PHP Commercial |
$948.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$970.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$776.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$981.87
|
| Rate for Payer: UHC Core |
$931.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.82
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.71 |
| Max. Negotiated Rate |
$1,004.18 |
| Rate for Payer: Aetna Commercial |
$948.40
|
| Rate for Payer: Aetna Medicare |
$290.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.68
|
| Rate for Payer: BCBS Complete |
$206.53
|
| Rate for Payer: BCBS MAPPO |
$278.94
|
| Rate for Payer: BCBS Trust/PPO |
$917.27
|
| Rate for Payer: BCN Commercial |
$917.27
|
| Rate for Payer: BCN Medicare Advantage |
$278.94
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Commercial |
$959.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.94
|
| Rate for Payer: Healthscope Commercial |
$1,004.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.82
|
| Rate for Payer: Mclaren Medicaid |
$196.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.89
|
| Rate for Payer: Meridian Medicaid |
$206.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Nomi Health Commercial |
$914.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: PACE Senior Care Partners |
$264.99
|
| Rate for Payer: PACE SWMI |
$278.94
|
| Rate for Payer: PHP Commercial |
$948.40
|
| Rate for Payer: PHP Medicare Advantage |
$278.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$970.71
|
| Rate for Payer: Priority Health Medicare |
$281.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$776.57
|
| Rate for Payer: Railroad Medicare Medicare |
$278.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$981.87
|
| Rate for Payer: UHC Core |
$931.66
|
| Rate for Payer: UHC Exchange |
$278.94
|
| Rate for Payer: UHC Medicaid |
$196.71
|
| Rate for Payer: UHC Medicare Advantage |
$278.94
|
| Rate for Payer: UHCCP Medicaid |
$196.71
|
| Rate for Payer: VA VA |
$278.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.82
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,149.77 |
| Max. Negotiated Rate |
$2,779.88 |
| Rate for Payer: Aetna Commercial |
$2,625.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,551.00
|
| Rate for Payer: BCN Commercial |
$2,551.00
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Commercial |
$2,656.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Commercial |
$2,779.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,316.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Nomi Health Commercial |
$2,532.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: PHP Commercial |
$2,625.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,687.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,149.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,718.10
|
| Rate for Payer: UHC Core |
$2,579.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,316.56
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$544.55 |
| Max. Negotiated Rate |
$2,779.88 |
| Rate for Payer: Aetna Commercial |
$2,625.44
|
| Rate for Payer: Aetna Medicare |
$803.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$965.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$965.23
|
| Rate for Payer: BCBS Complete |
$571.73
|
| Rate for Payer: BCBS MAPPO |
$772.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.26
|
| Rate for Payer: BCN Commercial |
$2,539.26
|
| Rate for Payer: BCN Medicare Advantage |
$772.19
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Commercial |
$2,656.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.19
|
| Rate for Payer: Healthscope Commercial |
$2,779.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,316.56
|
| Rate for Payer: Mclaren Medicaid |
$544.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$810.80
|
| Rate for Payer: Meridian Medicaid |
$571.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$849.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Nomi Health Commercial |
$2,532.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: PACE Senior Care Partners |
$733.58
|
| Rate for Payer: PACE SWMI |
$772.19
|
| Rate for Payer: PHP Commercial |
$2,625.44
|
| Rate for Payer: PHP Medicare Advantage |
$772.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$544.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,687.21
|
| Rate for Payer: Priority Health Medicare |
$779.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,149.77
|
| Rate for Payer: Railroad Medicare Medicare |
$772.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,718.10
|
| Rate for Payer: UHC Core |
$2,579.11
|
| Rate for Payer: UHC Exchange |
$772.19
|
| Rate for Payer: UHC Medicaid |
$544.55
|
| Rate for Payer: UHC Medicare Advantage |
$772.19
|
| Rate for Payer: UHCCP Medicaid |
$544.55
|
| Rate for Payer: VA VA |
$772.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,316.56
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$233.70 |
| Max. Negotiated Rate |
$1,193.03 |
| Rate for Payer: Aetna Commercial |
$1,126.75
|
| Rate for Payer: Aetna Medicare |
$344.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$414.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$414.25
|
| Rate for Payer: BCBS Complete |
$245.37
|
| Rate for Payer: BCBS MAPPO |
$331.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.77
|
| Rate for Payer: BCN Commercial |
$1,089.77
|
| Rate for Payer: BCN Medicare Advantage |
$331.40
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Commercial |
$1,140.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.40
|
| Rate for Payer: Healthscope Commercial |
$1,193.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.19
|
| Rate for Payer: Mclaren Medicaid |
$233.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.97
|
| Rate for Payer: Meridian Medicaid |
$245.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$381.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$364.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.75
|
| Rate for Payer: Nomi Health Commercial |
$1,086.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: PACE Senior Care Partners |
$314.83
|
| Rate for Payer: PACE SWMI |
$331.40
|
| Rate for Payer: PHP Commercial |
$1,126.75
|
| Rate for Payer: PHP Medicare Advantage |
$331.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,153.26
|
| Rate for Payer: Priority Health Medicare |
$334.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.61
|
| Rate for Payer: Railroad Medicare Medicare |
$331.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,166.52
|
| Rate for Payer: UHC Core |
$1,106.87
|
| Rate for Payer: UHC Exchange |
$331.40
|
| Rate for Payer: UHC Medicaid |
$233.70
|
| Rate for Payer: UHC Medicare Advantage |
$331.40
|
| Rate for Payer: UHCCP Medicaid |
$233.70
|
| Rate for Payer: VA VA |
$331.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.19
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$922.61 |
| Max. Negotiated Rate |
$1,193.03 |
| Rate for Payer: Aetna Commercial |
$1,126.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.80
|
| Rate for Payer: BCN Commercial |
$1,094.80
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Commercial |
$1,140.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Healthscope Commercial |
$1,193.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.75
|
| Rate for Payer: Nomi Health Commercial |
$1,086.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: PHP Commercial |
$1,126.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,153.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,166.52
|
| Rate for Payer: UHC Core |
$1,106.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.19
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.09 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: BCBS Trust/PPO |
$491.37
|
| Rate for Payer: BCN Commercial |
$491.37
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.89 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.92
|
| Rate for Payer: BCBS Complete |
$110.13
|
| Rate for Payer: BCBS MAPPO |
$148.74
|
| Rate for Payer: BCBS Trust/PPO |
$489.11
|
| Rate for Payer: BCN Commercial |
$489.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.74
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.74
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Mclaren Medicaid |
$104.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.17
|
| Rate for Payer: Meridian Medicaid |
$110.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Senior Care Partners |
$141.30
|
| Rate for Payer: PACE SWMI |
$148.74
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$148.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Medicare |
$150.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: Railroad Medicare Medicare |
$148.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: UHC Exchange |
$148.74
|
| Rate for Payer: UHC Medicaid |
$104.89
|
| Rate for Payer: UHC Medicare Advantage |
$148.74
|
| Rate for Payer: UHCCP Medicaid |
$104.89
|
| Rate for Payer: VA VA |
$148.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$660.76 |
| Max. Negotiated Rate |
$3,373.16 |
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: Aetna Medicare |
$974.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,171.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,171.23
|
| Rate for Payer: BCBS Complete |
$693.75
|
| Rate for Payer: BCBS MAPPO |
$936.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,081.19
|
| Rate for Payer: BCN Commercial |
$3,081.19
|
| Rate for Payer: BCN Medicare Advantage |
$936.99
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.99
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| Rate for Payer: Mclaren Medicaid |
$660.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.84
|
| Rate for Payer: Meridian Medicaid |
$693.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,077.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,030.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Nomi Health Commercial |
$3,073.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PACE Senior Care Partners |
$890.14
|
| Rate for Payer: PACE SWMI |
$936.99
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| Rate for Payer: PHP Medicare Advantage |
$936.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,260.72
|
| Rate for Payer: Priority Health Medicare |
$946.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,608.57
|
| Rate for Payer: Railroad Medicare Medicare |
$936.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,298.20
|
| Rate for Payer: UHC Core |
$3,129.54
|
| Rate for Payer: UHC Exchange |
$936.99
|
| Rate for Payer: UHC Medicaid |
$660.76
|
| Rate for Payer: UHC Medicare Advantage |
$936.99
|
| Rate for Payer: UHCCP Medicaid |
$660.76
|
| Rate for Payer: VA VA |
$936.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,608.57 |
| Max. Negotiated Rate |
$3,373.16 |
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,095.43
|
| Rate for Payer: BCN Commercial |
$3,095.43
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Nomi Health Commercial |
$3,073.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,260.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,608.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,298.20
|
| Rate for Payer: UHC Core |
$3,129.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$165.21 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna Medicare |
$243.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.84
|
| Rate for Payer: BCBS Complete |
$173.45
|
| Rate for Payer: BCBS MAPPO |
$234.27
|
| Rate for Payer: BCBS Trust/PPO |
$770.37
|
| Rate for Payer: BCN Commercial |
$770.37
|
| Rate for Payer: BCN Medicare Advantage |
$234.27
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.27
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Mclaren Medicaid |
$165.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.98
|
| Rate for Payer: Meridian Medicaid |
$173.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$257.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PACE Senior Care Partners |
$222.56
|
| Rate for Payer: PACE SWMI |
$234.27
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: PHP Medicare Advantage |
$234.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.26
|
| Rate for Payer: Priority Health Medicare |
$236.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.21
|
| Rate for Payer: Railroad Medicare Medicare |
$234.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.63
|
| Rate for Payer: UHC Core |
$782.46
|
| Rate for Payer: UHC Exchange |
$234.27
|
| Rate for Payer: UHC Medicaid |
$165.21
|
| Rate for Payer: UHC Medicare Advantage |
$234.27
|
| Rate for Payer: UHCCP Medicaid |
$165.21
|
| Rate for Payer: VA VA |
$234.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$652.21 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: BCBS Trust/PPO |
$773.93
|
| Rate for Payer: BCN Commercial |
$773.93
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.63
|
| Rate for Payer: UHC Core |
$782.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$719.25 |
| Max. Negotiated Rate |
$930.07 |
| Rate for Payer: Aetna Commercial |
$878.40
|
| Rate for Payer: BCBS Trust/PPO |
$853.49
|
| Rate for Payer: BCN Commercial |
$853.49
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Commercial |
$888.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Healthscope Commercial |
$930.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.40
|
| Rate for Payer: Nomi Health Commercial |
$847.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: PHP Commercial |
$878.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.40
|
| Rate for Payer: UHC Core |
$862.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.06
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$182.19 |
| Max. Negotiated Rate |
$930.07 |
| Rate for Payer: Aetna Commercial |
$878.40
|
| Rate for Payer: Aetna Medicare |
$268.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.94
|
| Rate for Payer: BCBS Complete |
$191.28
|
| Rate for Payer: BCBS MAPPO |
$258.35
|
| Rate for Payer: BCBS Trust/PPO |
$849.57
|
| Rate for Payer: BCN Commercial |
$849.57
|
| Rate for Payer: BCN Medicare Advantage |
$258.35
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Commercial |
$888.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.35
|
| Rate for Payer: Healthscope Commercial |
$930.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.06
|
| Rate for Payer: Mclaren Medicaid |
$182.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.27
|
| Rate for Payer: Meridian Medicaid |
$191.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$284.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.40
|
| Rate for Payer: Nomi Health Commercial |
$847.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: PACE Senior Care Partners |
$245.43
|
| Rate for Payer: PACE SWMI |
$258.35
|
| Rate for Payer: PHP Commercial |
$878.40
|
| Rate for Payer: PHP Medicare Advantage |
$258.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$899.07
|
| Rate for Payer: Priority Health Medicare |
$260.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.25
|
| Rate for Payer: Railroad Medicare Medicare |
$258.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.40
|
| Rate for Payer: UHC Core |
$862.90
|
| Rate for Payer: UHC Exchange |
$258.35
|
| Rate for Payer: UHC Medicaid |
$182.19
|
| Rate for Payer: UHC Medicare Advantage |
$258.35
|
| Rate for Payer: UHCCP Medicaid |
$182.19
|
| Rate for Payer: VA VA |
$258.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.06
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$966.10 |
| Max. Negotiated Rate |
$1,249.26 |
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,146.41
|
| Rate for Payer: BCN Commercial |
$1,146.41
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$1,138.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,207.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$966.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.50
|
| Rate for Payer: UHC Core |
$1,159.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$244.72 |
| Max. Negotiated Rate |
$1,249.26 |
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: Aetna Medicare |
$360.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$433.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$433.77
|
| Rate for Payer: BCBS Complete |
$256.93
|
| Rate for Payer: BCBS MAPPO |
$347.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.13
|
| Rate for Payer: BCN Commercial |
$1,141.13
|
| Rate for Payer: BCN Medicare Advantage |
$347.02
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.02
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| Rate for Payer: Mclaren Medicaid |
$244.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.37
|
| Rate for Payer: Meridian Medicaid |
$256.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$381.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$1,138.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PACE Senior Care Partners |
$329.67
|
| Rate for Payer: PACE SWMI |
$347.02
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| Rate for Payer: PHP Medicare Advantage |
$347.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$244.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,207.62
|
| Rate for Payer: Priority Health Medicare |
$350.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$966.10
|
| Rate for Payer: Railroad Medicare Medicare |
$347.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.50
|
| Rate for Payer: UHC Core |
$1,159.04
|
| Rate for Payer: UHC Exchange |
$347.02
|
| Rate for Payer: UHC Medicaid |
$244.72
|
| Rate for Payer: UHC Medicare Advantage |
$347.02
|
| Rate for Payer: UHCCP Medicaid |
$244.72
|
| Rate for Payer: VA VA |
$347.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: Aetna Medicare |
$12.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.64
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.52
|
| Rate for Payer: BCN Commercial |
$38.52
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Mclaren Medicaid |
$8.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.30
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PACE Senior Care Partners |
$11.13
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.76
|
| Rate for Payer: Priority Health Medicare |
$11.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.61
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.23
|
| Rate for Payer: UHC Core |
$39.12
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.26
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.26
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.61 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: BCBS Trust/PPO |
$38.69
|
| Rate for Payer: BCN Commercial |
$38.69
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.23
|
| Rate for Payer: UHC Core |
$39.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
