|
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
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$409.09 |
| Max. Negotiated Rate |
$529.00 |
| Rate for Payer: Aetna Commercial |
$499.61
|
| Rate for Payer: BCBS Trust/PPO |
$485.45
|
| Rate for Payer: BCN Commercial |
$485.45
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Commercial |
$505.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Healthscope Commercial |
$529.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Nomi Health Commercial |
$481.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: PHP Commercial |
$499.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.25
|
| Rate for Payer: UHC Core |
$490.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.83
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$103.63 |
| Max. Negotiated Rate |
$529.00 |
| Rate for Payer: Aetna Commercial |
$499.61
|
| Rate for Payer: Aetna Medicare |
$152.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.68
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$146.94
|
| Rate for Payer: BCBS Trust/PPO |
$483.21
|
| Rate for Payer: BCN Commercial |
$483.21
|
| Rate for Payer: BCN Medicare Advantage |
$146.94
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Commercial |
$505.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.94
|
| Rate for Payer: Healthscope Commercial |
$529.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.83
|
| Rate for Payer: Mclaren Medicaid |
$103.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.29
|
| Rate for Payer: Meridian Medicaid |
$108.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Nomi Health Commercial |
$481.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: PACE Senior Care Partners |
$139.60
|
| Rate for Payer: PACE SWMI |
$146.94
|
| Rate for Payer: PHP Commercial |
$499.61
|
| Rate for Payer: PHP Medicare Advantage |
$146.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.37
|
| Rate for Payer: Priority Health Medicare |
$148.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.09
|
| Rate for Payer: Railroad Medicare Medicare |
$146.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.25
|
| Rate for Payer: UHC Core |
$490.80
|
| Rate for Payer: UHC Exchange |
$146.94
|
| Rate for Payer: UHC Medicaid |
$103.63
|
| Rate for Payer: UHC Medicare Advantage |
$146.94
|
| Rate for Payer: UHCCP Medicaid |
$103.63
|
| Rate for Payer: VA VA |
$146.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.83
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,261.60 |
| Max. Negotiated Rate |
$10,683.11 |
| Rate for Payer: Aetna Commercial |
$10,089.60
|
| Rate for Payer: BCBS Trust/PPO |
$9,803.53
|
| Rate for Payer: BCN Commercial |
$9,803.53
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Commercial |
$10,208.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Healthscope Commercial |
$10,683.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,902.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Nomi Health Commercial |
$9,733.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: PHP Commercial |
$10,089.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,327.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,261.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,445.71
|
| Rate for Payer: UHC Core |
$9,911.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,902.59
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,092.70 |
| Max. Negotiated Rate |
$10,683.11 |
| Rate for Payer: Aetna Commercial |
$10,089.60
|
| Rate for Payer: Aetna Medicare |
$3,086.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,709.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,709.41
|
| Rate for Payer: BCBS Complete |
$2,197.16
|
| Rate for Payer: BCBS MAPPO |
$2,967.53
|
| Rate for Payer: BCBS Trust/PPO |
$9,758.43
|
| Rate for Payer: BCN Commercial |
$9,758.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,967.53
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Commercial |
$10,208.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,967.53
|
| Rate for Payer: Healthscope Commercial |
$10,683.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,902.59
|
| Rate for Payer: Mclaren Medicaid |
$2,092.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,115.91
|
| Rate for Payer: Meridian Medicaid |
$2,197.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,412.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,264.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Nomi Health Commercial |
$9,733.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: PACE Senior Care Partners |
$2,819.15
|
| Rate for Payer: PACE SWMI |
$2,967.53
|
| Rate for Payer: PHP Commercial |
$10,089.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,967.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,092.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,327.00
|
| Rate for Payer: Priority Health Medicare |
$2,997.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,261.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,967.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,445.71
|
| Rate for Payer: UHC Core |
$9,911.55
|
| Rate for Payer: UHC Exchange |
$2,967.53
|
| Rate for Payer: UHC Medicaid |
$2,092.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,967.53
|
| Rate for Payer: UHCCP Medicaid |
$2,092.70
|
| Rate for Payer: VA VA |
$2,967.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,902.59
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,454.62 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,912.74
|
| Rate for Payer: BCN Commercial |
$2,912.74
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$621.77 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: Aetna Medicare |
$916.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,102.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,102.11
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: BCBS MAPPO |
$881.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.34
|
| Rate for Payer: BCN Commercial |
$2,899.34
|
| Rate for Payer: BCN Medicare Advantage |
$881.69
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.69
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Mclaren Medicaid |
$621.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.77
|
| Rate for Payer: Meridian Medicaid |
$652.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PACE Senior Care Partners |
$837.60
|
| Rate for Payer: PACE SWMI |
$881.69
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Medicare |
$890.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: Railroad Medicare Medicare |
$881.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: UHC Exchange |
$881.69
|
| Rate for Payer: UHC Medicaid |
$621.77
|
| Rate for Payer: UHC Medicare Advantage |
$881.69
|
| Rate for Payer: UHCCP Medicaid |
$621.77
|
| Rate for Payer: VA VA |
$881.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,834.96 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Aetna Commercial |
$4,683.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,550.71
|
| Rate for Payer: BCN Commercial |
$4,550.71
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Commercial |
$4,738.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Healthscope Commercial |
$4,959.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,132.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Nomi Health Commercial |
$4,518.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: PHP Commercial |
$4,683.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,793.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,834.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,848.80
|
| Rate for Payer: UHC Core |
$4,600.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,132.50
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$971.41 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Aetna Commercial |
$4,683.50
|
| Rate for Payer: Aetna Medicare |
$1,432.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,721.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,721.88
|
| Rate for Payer: BCBS Complete |
$1,019.90
|
| Rate for Payer: BCBS MAPPO |
$1,377.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,529.77
|
| Rate for Payer: BCN Commercial |
$4,529.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,377.50
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Commercial |
$4,738.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,377.50
|
| Rate for Payer: Healthscope Commercial |
$4,959.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,132.50
|
| Rate for Payer: Mclaren Medicaid |
$971.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,446.38
|
| Rate for Payer: Meridian Medicaid |
$1,019.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,584.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,515.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Nomi Health Commercial |
$4,518.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,308.62
|
| Rate for Payer: PACE SWMI |
$1,377.50
|
| Rate for Payer: PHP Commercial |
$4,683.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,377.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$971.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,793.70
|
| Rate for Payer: Priority Health Medicare |
$1,391.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,834.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,377.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,848.80
|
| Rate for Payer: UHC Core |
$4,600.85
|
| Rate for Payer: UHC Exchange |
$1,377.50
|
| Rate for Payer: UHC Medicaid |
$971.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,377.50
|
| Rate for Payer: UHCCP Medicaid |
$971.41
|
| Rate for Payer: VA VA |
$1,377.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,132.50
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,848.94 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna Medicare |
$2,726.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,277.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,277.33
|
| Rate for Payer: BCBS Complete |
$1,941.23
|
| Rate for Payer: BCBS MAPPO |
$2,621.86
|
| Rate for Payer: BCBS Trust/PPO |
$8,621.74
|
| Rate for Payer: BCN Commercial |
$8,621.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,621.86
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,621.86
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Mclaren Medicaid |
$1,848.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,752.96
|
| Rate for Payer: Meridian Medicaid |
$1,941.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,015.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,884.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PACE Senior Care Partners |
$2,490.77
|
| Rate for Payer: PACE SWMI |
$2,621.86
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,621.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,848.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,124.09
|
| Rate for Payer: Priority Health Medicare |
$2,648.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,299.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,621.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,228.96
|
| Rate for Payer: UHC Core |
$8,757.03
|
| Rate for Payer: UHC Exchange |
$2,621.86
|
| Rate for Payer: UHC Medicaid |
$1,848.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,621.86
|
| Rate for Payer: UHCCP Medicaid |
$1,848.94
|
| Rate for Payer: VA VA |
$2,621.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,299.27 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: BCBS Trust/PPO |
$8,661.59
|
| Rate for Payer: BCN Commercial |
$8,661.59
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,124.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,299.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,228.96
|
| Rate for Payer: UHC Core |
$8,757.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,848.94 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna Medicare |
$2,726.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,277.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,277.33
|
| Rate for Payer: BCBS Complete |
$1,941.23
|
| Rate for Payer: BCBS MAPPO |
$2,621.86
|
| Rate for Payer: BCBS Trust/PPO |
$8,621.74
|
| Rate for Payer: BCN Commercial |
$8,621.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,621.86
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,621.86
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Mclaren Medicaid |
$1,848.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,752.96
|
| Rate for Payer: Meridian Medicaid |
$1,941.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,015.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,884.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PACE Senior Care Partners |
$2,490.77
|
| Rate for Payer: PACE SWMI |
$2,621.86
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: PHP Medicare Advantage |
$2,621.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,848.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,124.09
|
| Rate for Payer: Priority Health Medicare |
$2,648.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,299.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,621.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,228.96
|
| Rate for Payer: UHC Core |
$8,757.03
|
| Rate for Payer: UHC Exchange |
$2,621.86
|
| Rate for Payer: UHC Medicaid |
$1,848.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,621.86
|
| Rate for Payer: UHCCP Medicaid |
$1,848.94
|
| Rate for Payer: VA VA |
$2,621.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,299.27 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: BCBS Trust/PPO |
$8,661.59
|
| Rate for Payer: BCN Commercial |
$8,661.59
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Nomi Health Commercial |
$8,599.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,124.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,299.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,228.96
|
| Rate for Payer: UHC Core |
$8,757.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,427.25 |
| Max. Negotiated Rate |
$1,845.59 |
| Rate for Payer: Aetna Commercial |
$1,743.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.63
|
| Rate for Payer: BCN Commercial |
$1,693.63
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Commercial |
$1,763.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Healthscope Commercial |
$1,845.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,743.05
|
| Rate for Payer: Nomi Health Commercial |
$1,681.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| Rate for Payer: PHP Commercial |
$1,743.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,784.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.57
|
| Rate for Payer: UHC Core |
$1,712.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.99
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$361.53 |
| Max. Negotiated Rate |
$1,845.59 |
| Rate for Payer: Aetna Commercial |
$1,743.05
|
| Rate for Payer: Aetna Medicare |
$533.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$640.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$640.83
|
| Rate for Payer: BCBS Complete |
$379.58
|
| Rate for Payer: BCBS MAPPO |
$512.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.84
|
| Rate for Payer: BCN Commercial |
$1,685.84
|
| Rate for Payer: BCN Medicare Advantage |
$512.66
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Commercial |
$1,763.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.66
|
| Rate for Payer: Healthscope Commercial |
$1,845.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.99
|
| Rate for Payer: Mclaren Medicaid |
$361.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.30
|
| Rate for Payer: Meridian Medicaid |
$379.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$589.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,743.05
|
| Rate for Payer: Nomi Health Commercial |
$1,681.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| Rate for Payer: PACE Senior Care Partners |
$487.03
|
| Rate for Payer: PACE SWMI |
$512.66
|
| Rate for Payer: PHP Commercial |
$1,743.05
|
| Rate for Payer: PHP Medicare Advantage |
$512.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,784.07
|
| Rate for Payer: Priority Health Medicare |
$517.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,427.25
|
| Rate for Payer: Railroad Medicare Medicare |
$512.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.57
|
| Rate for Payer: UHC Core |
$1,712.29
|
| Rate for Payer: UHC Exchange |
$512.66
|
| Rate for Payer: UHC Medicaid |
$361.53
|
| Rate for Payer: UHC Medicare Advantage |
$512.66
|
| Rate for Payer: UHCCP Medicaid |
$361.53
|
| Rate for Payer: VA VA |
$512.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.99
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
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 PULMONARY BILATERAL
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
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 IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.84 |
| Max. Negotiated Rate |
$113.58 |
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: BCBS Trust/PPO |
$104.23
|
| Rate for Payer: BCN Commercial |
$104.23
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Healthscope Commercial |
$113.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$103.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.06
|
| Rate for Payer: UHC Core |
$105.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.25 |
| Max. Negotiated Rate |
$113.58 |
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: Aetna Medicare |
$32.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.44
|
| Rate for Payer: BCBS Complete |
$23.36
|
| Rate for Payer: BCBS MAPPO |
$31.55
|
| Rate for Payer: BCBS Trust/PPO |
$103.75
|
| Rate for Payer: BCN Commercial |
$103.75
|
| Rate for Payer: BCN Medicare Advantage |
$31.55
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.55
|
| Rate for Payer: Healthscope Commercial |
$113.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.65
|
| Rate for Payer: Mclaren Medicaid |
$22.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.13
|
| Rate for Payer: Meridian Medicaid |
$23.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$103.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PACE Senior Care Partners |
$29.97
|
| Rate for Payer: PACE SWMI |
$31.55
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: PHP Medicare Advantage |
$31.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.79
|
| Rate for Payer: Priority Health Medicare |
$31.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.84
|
| Rate for Payer: Railroad Medicare Medicare |
$31.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.06
|
| Rate for Payer: UHC Core |
$105.38
|
| Rate for Payer: UHC Exchange |
$31.55
|
| Rate for Payer: UHC Medicaid |
$22.25
|
| Rate for Payer: UHC Medicare Advantage |
$31.55
|
| Rate for Payer: UHCCP Medicaid |
$22.25
|
| Rate for Payer: VA VA |
$31.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,474.40 |
| Max. Negotiated Rate |
$3,199.65 |
| Rate for Payer: Aetna Commercial |
$3,021.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,936.21
|
| Rate for Payer: BCN Commercial |
$2,936.21
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Commercial |
$3,057.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Healthscope Commercial |
$3,199.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,666.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,021.89
|
| Rate for Payer: Nomi Health Commercial |
$2,915.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| Rate for Payer: PHP Commercial |
$3,021.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,093.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,128.55
|
| Rate for Payer: UHC Core |
$2,968.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,666.38
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,555.17
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$626.78 |
| Max. Negotiated Rate |
$3,199.65 |
| Rate for Payer: Aetna Commercial |
$3,021.89
|
| Rate for Payer: Aetna Medicare |
$924.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,110.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,110.99
|
| Rate for Payer: BCBS Complete |
$658.06
|
| Rate for Payer: BCBS MAPPO |
$888.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,922.71
|
| Rate for Payer: BCN Commercial |
$2,922.71
|
| Rate for Payer: BCN Medicare Advantage |
$888.79
|
| Rate for Payer: Cash Price |
$2,844.14
|
| Rate for Payer: Cofinity Commercial |
$3,057.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,844.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.79
|
| Rate for Payer: Healthscope Commercial |
$3,199.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,666.38
|
| Rate for Payer: Mclaren Medicaid |
$626.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.23
|
| Rate for Payer: Meridian Medicaid |
$658.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$977.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,021.89
|
| Rate for Payer: Nomi Health Commercial |
$2,915.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,666.38
|
| Rate for Payer: PACE Senior Care Partners |
$844.35
|
| Rate for Payer: PACE SWMI |
$888.79
|
| Rate for Payer: PHP Commercial |
$3,021.89
|
| Rate for Payer: PHP Medicare Advantage |
$888.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$626.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,093.00
|
| Rate for Payer: Priority Health Medicare |
$897.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.40
|
| Rate for Payer: Railroad Medicare Medicare |
$888.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,128.55
|
| Rate for Payer: UHC Core |
$2,968.57
|
| Rate for Payer: UHC Exchange |
$888.79
|
| Rate for Payer: UHC Medicaid |
$626.78
|
| Rate for Payer: UHC Medicare Advantage |
$888.79
|
| Rate for Payer: UHCCP Medicaid |
$626.78
|
| Rate for Payer: VA VA |
$888.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,666.38
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,499.54 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$3,686.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,430.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,430.55
|
| Rate for Payer: BCBS Complete |
$2,624.30
|
| Rate for Payer: BCBS MAPPO |
$3,544.44
|
| Rate for Payer: BCBS Trust/PPO |
$11,655.53
|
| Rate for Payer: BCN Commercial |
$11,655.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,544.44
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,544.44
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Mclaren Medicaid |
$2,499.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,721.66
|
| Rate for Payer: Meridian Medicaid |
$2,624.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,076.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,898.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Senior Care Partners |
$3,367.22
|
| Rate for Payer: PACE SWMI |
$3,544.44
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,544.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,334.64
|
| Rate for Payer: Priority Health Medicare |
$3,579.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,867.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,544.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,476.42
|
| Rate for Payer: UHC Core |
$11,838.42
|
| Rate for Payer: UHC Exchange |
$3,544.44
|
| Rate for Payer: UHC Medicaid |
$2,499.54
|
| Rate for Payer: UHC Medicare Advantage |
$3,544.44
|
| Rate for Payer: UHCCP Medicaid |
$2,499.54
|
| Rate for Payer: VA VA |
$3,544.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT COMPLEX INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37256
|
| Hospital Charge Code |
36100637
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,867.71 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: BCBS Trust/PPO |
$11,709.40
|
| Rate for Payer: BCN Commercial |
$11,709.40
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,334.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,867.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,476.42
|
| Rate for Payer: UHC Core |
$11,838.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
IP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,867.71 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: BCBS Trust/PPO |
$11,709.40
|
| Rate for Payer: BCN Commercial |
$11,709.40
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,334.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,867.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,476.42
|
| Rate for Payer: UHC Core |
$11,838.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
|
HC IR REVASC IVT W ANGIO UNILAT SF INITIAL VESSEL
|
Facility
|
OP
|
$14,177.75
|
|
|
Service Code
|
CPT 37254
|
| Hospital Charge Code |
36100636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,499.54 |
| Max. Negotiated Rate |
$12,759.98 |
| Rate for Payer: Aetna Commercial |
$12,051.09
|
| Rate for Payer: Aetna Medicare |
$3,686.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,430.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,430.55
|
| Rate for Payer: BCBS Complete |
$2,624.30
|
| Rate for Payer: BCBS MAPPO |
$3,544.44
|
| Rate for Payer: BCBS Trust/PPO |
$11,655.53
|
| Rate for Payer: BCN Commercial |
$11,655.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,544.44
|
| Rate for Payer: Cash Price |
$11,342.20
|
| Rate for Payer: Cofinity Commercial |
$12,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,544.44
|
| Rate for Payer: Healthscope Commercial |
$12,759.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,633.31
|
| Rate for Payer: Mclaren Medicaid |
$2,499.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,721.66
|
| Rate for Payer: Meridian Medicaid |
$2,624.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,076.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,898.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,051.09
|
| Rate for Payer: Nomi Health Commercial |
$11,625.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,633.31
|
| Rate for Payer: PACE Senior Care Partners |
$3,367.22
|
| Rate for Payer: PACE SWMI |
$3,544.44
|
| Rate for Payer: PHP Commercial |
$12,051.09
|
| Rate for Payer: PHP Medicare Advantage |
$3,544.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,334.64
|
| Rate for Payer: Priority Health Medicare |
$3,579.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,867.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,544.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,476.42
|
| Rate for Payer: UHC Core |
$11,838.42
|
| Rate for Payer: UHC Exchange |
$3,544.44
|
| Rate for Payer: UHC Medicaid |
$2,499.54
|
| Rate for Payer: UHC Medicare Advantage |
$3,544.44
|
| Rate for Payer: UHCCP Medicaid |
$2,499.54
|
| Rate for Payer: VA VA |
$3,544.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,633.31
|
|
