|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$368.37
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna Medicare |
$95.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.12
|
| Rate for Payer: BCBS Complete |
$68.19
|
| Rate for Payer: BCBS MAPPO |
$92.09
|
| Rate for Payer: BCBS Trust/PPO |
$302.84
|
| Rate for Payer: BCN Commercial |
$302.84
|
| Rate for Payer: BCN Medicare Advantage |
$92.09
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.09
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Mclaren Medicaid |
$64.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.70
|
| Rate for Payer: Meridian Medicaid |
$68.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$302.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PACE Senior Care Partners |
$87.49
|
| Rate for Payer: PACE SWMI |
$92.09
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: PHP Medicare Advantage |
$92.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.48
|
| Rate for Payer: Priority Health Medicare |
$93.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.39
|
| Rate for Payer: Railroad Medicare Medicare |
$92.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.17
|
| Rate for Payer: UHC Core |
$307.59
|
| Rate for Payer: UHC Exchange |
$92.09
|
| Rate for Payer: UHC Medicaid |
$64.94
|
| Rate for Payer: UHC Medicare Advantage |
$92.09
|
| Rate for Payer: UHCCP Medicaid |
$64.94
|
| Rate for Payer: VA VA |
$92.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$368.37
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$256.39 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: BCBS Trust/PPO |
$304.24
|
| Rate for Payer: BCN Commercial |
$304.24
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$302.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.17
|
| Rate for Payer: UHC Core |
$307.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$18.43
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.83 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: BCBS Trust/PPO |
$15.22
|
| Rate for Payer: BCN Commercial |
$15.22
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$18.43
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Aetna Commercial |
$15.67
|
| Rate for Payer: Aetna Medicare |
$4.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.76
|
| Rate for Payer: BCBS Complete |
$3.41
|
| Rate for Payer: BCBS MAPPO |
$4.61
|
| Rate for Payer: BCBS Trust/PPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$15.15
|
| Rate for Payer: BCN Medicare Advantage |
$4.61
|
| Rate for Payer: Cash Price |
$14.74
|
| Rate for Payer: Cofinity Commercial |
$15.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.61
|
| Rate for Payer: Healthscope Commercial |
$16.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.82
|
| Rate for Payer: Mclaren Medicaid |
$3.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.84
|
| Rate for Payer: Meridian Medicaid |
$3.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.67
|
| Rate for Payer: Nomi Health Commercial |
$15.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.82
|
| Rate for Payer: PACE Senior Care Partners |
$4.38
|
| Rate for Payer: PACE SWMI |
$4.61
|
| Rate for Payer: PHP Commercial |
$15.67
|
| Rate for Payer: PHP Medicare Advantage |
$4.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.03
|
| Rate for Payer: Priority Health Medicare |
$4.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Railroad Medicare Medicare |
$4.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Core |
$15.39
|
| Rate for Payer: UHC Exchange |
$4.61
|
| Rate for Payer: UHC Medicaid |
$3.25
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: UHCCP Medicaid |
$3.25
|
| Rate for Payer: VA VA |
$4.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.82
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,998.93
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.41 |
| Max. Negotiated Rate |
$1,799.04 |
| Rate for Payer: Aetna Commercial |
$1,699.09
|
| Rate for Payer: Aetna Medicare |
$519.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$624.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$624.67
|
| Rate for Payer: BCBS Complete |
$370.00
|
| Rate for Payer: BCBS MAPPO |
$499.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.32
|
| Rate for Payer: BCN Commercial |
$1,643.32
|
| Rate for Payer: BCN Medicare Advantage |
$499.73
|
| Rate for Payer: Cash Price |
$1,599.14
|
| Rate for Payer: Cofinity Commercial |
$1,719.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.73
|
| Rate for Payer: Healthscope Commercial |
$1,799.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.20
|
| Rate for Payer: Mclaren Medicaid |
$352.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.72
|
| Rate for Payer: Meridian Medicaid |
$370.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$574.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.09
|
| Rate for Payer: Nomi Health Commercial |
$1,639.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.20
|
| Rate for Payer: PACE Senior Care Partners |
$474.75
|
| Rate for Payer: PACE SWMI |
$499.73
|
| Rate for Payer: PHP Commercial |
$1,699.09
|
| Rate for Payer: PHP Medicare Advantage |
$499.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,739.07
|
| Rate for Payer: Priority Health Medicare |
$504.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.26
|
| Rate for Payer: Railroad Medicare Medicare |
$499.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.06
|
| Rate for Payer: UHC Core |
$1,669.11
|
| Rate for Payer: UHC Exchange |
$499.73
|
| Rate for Payer: UHC Medicaid |
$352.41
|
| Rate for Payer: UHC Medicare Advantage |
$499.73
|
| Rate for Payer: UHCCP Medicaid |
$352.41
|
| Rate for Payer: VA VA |
$499.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.20
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,998.93
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,391.26 |
| Max. Negotiated Rate |
$1,799.04 |
| Rate for Payer: Aetna Commercial |
$1,699.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.92
|
| Rate for Payer: BCN Commercial |
$1,650.92
|
| Rate for Payer: Cash Price |
$1,599.14
|
| Rate for Payer: Cofinity Commercial |
$1,719.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.14
|
| Rate for Payer: Healthscope Commercial |
$1,799.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.09
|
| Rate for Payer: Nomi Health Commercial |
$1,639.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.20
|
| Rate for Payer: PHP Commercial |
$1,699.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,739.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.06
|
| Rate for Payer: UHC Core |
$1,669.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.20
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$238.77
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.18 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: BCBS Trust/PPO |
$197.20
|
| Rate for Payer: BCN Commercial |
$197.20
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR SHEATH
|
Facility
|
OP
|
$238.77
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.10 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna Medicare |
$62.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.62
|
| Rate for Payer: BCBS Complete |
$44.20
|
| Rate for Payer: BCBS MAPPO |
$59.69
|
| Rate for Payer: BCBS Trust/PPO |
$196.29
|
| Rate for Payer: BCN Commercial |
$196.29
|
| Rate for Payer: BCN Medicare Advantage |
$59.69
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.69
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Mclaren Medicaid |
$42.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.68
|
| Rate for Payer: Meridian Medicaid |
$44.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PACE Senior Care Partners |
$56.71
|
| Rate for Payer: PACE SWMI |
$59.69
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: PHP Medicare Advantage |
$59.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Medicare |
$60.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: Railroad Medicare Medicare |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: UHC Exchange |
$59.69
|
| Rate for Payer: UHC Medicaid |
$42.10
|
| Rate for Payer: UHC Medicare Advantage |
$59.69
|
| Rate for Payer: UHCCP Medicaid |
$42.10
|
| Rate for Payer: VA VA |
$59.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$743.65
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.11 |
| Max. Negotiated Rate |
$669.28 |
| Rate for Payer: Aetna Commercial |
$632.10
|
| Rate for Payer: Aetna Medicare |
$193.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$232.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$232.39
|
| Rate for Payer: BCBS Complete |
$137.65
|
| Rate for Payer: BCBS MAPPO |
$185.91
|
| Rate for Payer: BCBS Trust/PPO |
$611.35
|
| Rate for Payer: BCN Commercial |
$611.35
|
| Rate for Payer: BCN Medicare Advantage |
$185.91
|
| Rate for Payer: Cash Price |
$594.92
|
| Rate for Payer: Cofinity Commercial |
$639.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.91
|
| Rate for Payer: Healthscope Commercial |
$669.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.74
|
| Rate for Payer: Mclaren Medicaid |
$131.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.21
|
| Rate for Payer: Meridian Medicaid |
$137.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$204.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$632.10
|
| Rate for Payer: Nomi Health Commercial |
$609.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$557.74
|
| Rate for Payer: PACE Senior Care Partners |
$176.62
|
| Rate for Payer: PACE SWMI |
$185.91
|
| Rate for Payer: PHP Commercial |
$632.10
|
| Rate for Payer: PHP Medicare Advantage |
$185.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$646.98
|
| Rate for Payer: Priority Health Medicare |
$187.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.58
|
| Rate for Payer: Railroad Medicare Medicare |
$185.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.41
|
| Rate for Payer: UHC Core |
$620.95
|
| Rate for Payer: UHC Exchange |
$185.91
|
| Rate for Payer: UHC Medicaid |
$131.11
|
| Rate for Payer: UHC Medicare Advantage |
$185.91
|
| Rate for Payer: UHCCP Medicaid |
$131.11
|
| Rate for Payer: VA VA |
$185.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.74
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$743.65
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$517.58 |
| Max. Negotiated Rate |
$669.28 |
| Rate for Payer: Aetna Commercial |
$632.10
|
| Rate for Payer: BCBS Trust/PPO |
$614.18
|
| Rate for Payer: BCN Commercial |
$614.18
|
| Rate for Payer: Cash Price |
$594.92
|
| Rate for Payer: Cofinity Commercial |
$639.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.92
|
| Rate for Payer: Healthscope Commercial |
$669.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$632.10
|
| Rate for Payer: Nomi Health Commercial |
$609.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$557.74
|
| Rate for Payer: PHP Commercial |
$632.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$646.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$654.41
|
| Rate for Payer: UHC Core |
$620.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.74
|
|
|
HC IR SIALOGRAM
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 SIALOGRAM
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$1,492.33
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$263.10 |
| Max. Negotiated Rate |
$1,343.10 |
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: Aetna Medicare |
$258.67
|
| Rate for Payer: Aetna Medicare |
$388.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.90
|
| Rate for Payer: BCBS Complete |
$276.23
|
| Rate for Payer: BCBS Complete |
$184.15
|
| Rate for Payer: BCBS MAPPO |
$373.08
|
| Rate for Payer: BCBS MAPPO |
$248.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.84
|
| Rate for Payer: BCBS Trust/PPO |
$817.90
|
| Rate for Payer: BCN Commercial |
$817.90
|
| Rate for Payer: BCN Commercial |
$1,226.84
|
| Rate for Payer: BCN Medicare Advantage |
$248.72
|
| Rate for Payer: BCN Medicare Advantage |
$373.08
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.08
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Mclaren Medicaid |
$175.40
|
| Rate for Payer: Mclaren Medicaid |
$263.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.74
|
| Rate for Payer: Meridian Medicaid |
$276.23
|
| Rate for Payer: Meridian Medicaid |
$184.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PACE Senior Care Partners |
$236.29
|
| Rate for Payer: PACE Senior Care Partners |
$354.43
|
| Rate for Payer: PACE SWMI |
$248.72
|
| Rate for Payer: PACE SWMI |
$373.08
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: PHP Medicare Advantage |
$373.08
|
| Rate for Payer: PHP Medicare Advantage |
$248.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.33
|
| Rate for Payer: Priority Health Medicare |
$251.21
|
| Rate for Payer: Priority Health Medicare |
$376.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.44
|
| Rate for Payer: Railroad Medicare Medicare |
$373.08
|
| Rate for Payer: Railroad Medicare Medicare |
$248.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.50
|
| Rate for Payer: UHC Core |
$830.73
|
| Rate for Payer: UHC Core |
$1,246.10
|
| Rate for Payer: UHC Exchange |
$248.72
|
| Rate for Payer: UHC Exchange |
$373.08
|
| Rate for Payer: UHC Medicaid |
$175.40
|
| Rate for Payer: UHC Medicaid |
$263.10
|
| Rate for Payer: UHC Medicare Advantage |
$373.08
|
| Rate for Payer: UHC Medicare Advantage |
$248.72
|
| Rate for Payer: UHCCP Medicaid |
$263.10
|
| Rate for Payer: UHCCP Medicaid |
$175.40
|
| Rate for Payer: VA VA |
$373.08
|
| Rate for Payer: VA VA |
$248.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$1,492.33
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,038.66 |
| Max. Negotiated Rate |
$1,343.10 |
| Rate for Payer: Aetna Commercial |
$1,268.48
|
| Rate for Payer: Aetna Commercial |
$845.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.52
|
| Rate for Payer: BCBS Trust/PPO |
$821.68
|
| Rate for Payer: BCN Commercial |
$1,232.52
|
| Rate for Payer: BCN Commercial |
$821.68
|
| Rate for Payer: Cash Price |
$1,193.86
|
| Rate for Payer: Cash Price |
$795.91
|
| Rate for Payer: Cofinity Commercial |
$855.61
|
| Rate for Payer: Cofinity Commercial |
$1,283.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.86
|
| Rate for Payer: Healthscope Commercial |
$1,343.10
|
| Rate for Payer: Healthscope Commercial |
$895.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.66
|
| Rate for Payer: Nomi Health Commercial |
$1,223.71
|
| Rate for Payer: Nomi Health Commercial |
$815.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.17
|
| Rate for Payer: PHP Commercial |
$845.66
|
| Rate for Payer: PHP Commercial |
$1,268.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.50
|
| Rate for Payer: UHC Core |
$1,246.10
|
| Rate for Payer: UHC Core |
$830.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.17
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.11
|
| Rate for Payer: BCBS Complete |
$77.07
|
| Rate for Payer: BCBS MAPPO |
$104.09
|
| Rate for Payer: BCBS Trust/PPO |
$342.29
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$73.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.29
|
| Rate for Payer: Meridian Medicaid |
$77.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Senior Care Partners |
$98.89
|
| Rate for Payer: PACE SWMI |
$104.09
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: Railroad Medicare Medicare |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$104.09
|
| Rate for Payer: UHC Medicaid |
$73.40
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
| Rate for Payer: UHCCP Medicaid |
$73.40
|
| Rate for Payer: VA VA |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$281.97 |
| Max. Negotiated Rate |
$1,439.46 |
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: Aetna Medicare |
$415.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$499.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$499.81
|
| Rate for Payer: BCBS Complete |
$296.05
|
| Rate for Payer: BCBS MAPPO |
$399.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.87
|
| Rate for Payer: BCN Commercial |
$1,314.87
|
| Rate for Payer: BCN Medicare Advantage |
$399.85
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.85
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: Mclaren Medicaid |
$281.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.84
|
| Rate for Payer: Meridian Medicaid |
$296.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$459.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PACE Senior Care Partners |
$379.86
|
| Rate for Payer: PACE SWMI |
$399.85
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: PHP Medicare Advantage |
$399.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,391.48
|
| Rate for Payer: Priority Health Medicare |
$403.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.18
|
| Rate for Payer: Railroad Medicare Medicare |
$399.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.47
|
| Rate for Payer: UHC Core |
$1,335.50
|
| Rate for Payer: UHC Exchange |
$399.85
|
| Rate for Payer: UHC Medicaid |
$281.97
|
| Rate for Payer: UHC Medicare Advantage |
$399.85
|
| Rate for Payer: UHCCP Medicaid |
$281.97
|
| Rate for Payer: VA VA |
$399.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,599.40
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,113.18 |
| Max. Negotiated Rate |
$1,439.46 |
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.94
|
| Rate for Payer: BCN Commercial |
$1,320.94
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,391.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.47
|
| Rate for Payer: UHC Core |
$1,335.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$683.64 |
| Max. Negotiated Rate |
$3,489.93 |
| Rate for Payer: Aetna Commercial |
$3,296.05
|
| Rate for Payer: Aetna Medicare |
$1,008.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,211.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,211.78
|
| Rate for Payer: BCBS Complete |
$717.76
|
| Rate for Payer: BCBS MAPPO |
$969.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,187.86
|
| Rate for Payer: BCN Commercial |
$3,187.86
|
| Rate for Payer: BCN Medicare Advantage |
$969.42
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,334.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.42
|
| Rate for Payer: Healthscope Commercial |
$3,489.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.28
|
| Rate for Payer: Mclaren Medicaid |
$683.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.90
|
| Rate for Payer: Meridian Medicaid |
$717.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,114.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: PACE Senior Care Partners |
$920.95
|
| Rate for Payer: PACE SWMI |
$969.42
|
| Rate for Payer: PHP Commercial |
$3,296.05
|
| Rate for Payer: PHP Medicare Advantage |
$969.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$683.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,373.60
|
| Rate for Payer: Priority Health Medicare |
$979.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,698.88
|
| Rate for Payer: Railroad Medicare Medicare |
$969.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,412.38
|
| Rate for Payer: UHC Core |
$3,237.88
|
| Rate for Payer: UHC Exchange |
$969.42
|
| Rate for Payer: UHC Medicaid |
$683.64
|
| Rate for Payer: UHC Medicare Advantage |
$969.42
|
| Rate for Payer: UHCCP Medicaid |
$683.64
|
| Rate for Payer: VA VA |
$969.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.28
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,877.70
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,698.88 |
| Max. Negotiated Rate |
$3,489.93 |
| Rate for Payer: Aetna Commercial |
$3,296.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,202.59
|
| Rate for Payer: BCN Commercial |
$3,202.59
|
| Rate for Payer: Cash Price |
$3,102.16
|
| Rate for Payer: Cofinity Commercial |
$3,334.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.16
|
| Rate for Payer: Healthscope Commercial |
$3,489.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.05
|
| Rate for Payer: Nomi Health Commercial |
$3,179.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,908.28
|
| Rate for Payer: PHP Commercial |
$3,296.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,373.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,698.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,412.38
|
| Rate for Payer: UHC Core |
$3,237.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.28
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,884.27 |
| Max. Negotiated Rate |
$2,436.56 |
| Rate for Payer: Aetna Commercial |
$2,301.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,235.95
|
| Rate for Payer: BCN Commercial |
$2,235.95
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Commercial |
$2,328.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Healthscope Commercial |
$2,436.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,030.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Nomi Health Commercial |
$2,219.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: PHP Commercial |
$2,301.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,355.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,884.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,382.42
|
| Rate for Payer: UHC Core |
$2,260.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,030.47
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,707.29
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$477.30 |
| Max. Negotiated Rate |
$2,436.56 |
| Rate for Payer: Aetna Commercial |
$2,301.20
|
| Rate for Payer: Aetna Medicare |
$703.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$846.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$846.03
|
| Rate for Payer: BCBS Complete |
$501.12
|
| Rate for Payer: BCBS MAPPO |
$676.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,225.66
|
| Rate for Payer: BCN Commercial |
$2,225.66
|
| Rate for Payer: BCN Medicare Advantage |
$676.82
|
| Rate for Payer: Cash Price |
$2,165.83
|
| Rate for Payer: Cofinity Commercial |
$2,328.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,165.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.82
|
| Rate for Payer: Healthscope Commercial |
$2,436.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,030.47
|
| Rate for Payer: Mclaren Medicaid |
$477.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.66
|
| Rate for Payer: Meridian Medicaid |
$501.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$778.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$744.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,301.20
|
| Rate for Payer: Nomi Health Commercial |
$2,219.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.47
|
| Rate for Payer: PACE Senior Care Partners |
$642.98
|
| Rate for Payer: PACE SWMI |
$676.82
|
| Rate for Payer: PHP Commercial |
$2,301.20
|
| Rate for Payer: PHP Medicare Advantage |
$676.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,355.34
|
| Rate for Payer: Priority Health Medicare |
$683.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,884.27
|
| Rate for Payer: Railroad Medicare Medicare |
$676.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,382.42
|
| Rate for Payer: UHC Core |
$2,260.59
|
| Rate for Payer: UHC Exchange |
$676.82
|
| Rate for Payer: UHC Medicaid |
$477.30
|
| Rate for Payer: UHC Medicare Advantage |
$676.82
|
| Rate for Payer: UHCCP Medicaid |
$477.30
|
| Rate for Payer: VA VA |
$676.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,030.47
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,008.03 |
| Max. Negotiated Rate |
$7,769.00 |
| Rate for Payer: Aetna Commercial |
$7,337.39
|
| Rate for Payer: BCBS Trust/PPO |
$7,129.35
|
| Rate for Payer: BCN Commercial |
$7,129.35
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Commercial |
$7,423.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Healthscope Commercial |
$7,769.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,474.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,337.39
|
| Rate for Payer: Nomi Health Commercial |
$7,078.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| Rate for Payer: PHP Commercial |
$7,337.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,510.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,008.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,596.35
|
| Rate for Payer: UHC Core |
$7,207.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,474.16
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,632.22
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,521.86 |
| Max. Negotiated Rate |
$7,769.00 |
| Rate for Payer: Aetna Commercial |
$7,337.39
|
| Rate for Payer: Aetna Medicare |
$2,244.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,697.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,697.57
|
| Rate for Payer: BCBS Complete |
$1,597.82
|
| Rate for Payer: BCBS MAPPO |
$2,158.05
|
| Rate for Payer: BCBS Trust/PPO |
$7,096.55
|
| Rate for Payer: BCN Commercial |
$7,096.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,158.05
|
| Rate for Payer: Cash Price |
$6,905.78
|
| Rate for Payer: Cofinity Commercial |
$7,423.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,905.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,158.05
|
| Rate for Payer: Healthscope Commercial |
$7,769.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,474.16
|
| Rate for Payer: Mclaren Medicaid |
$1,521.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,265.96
|
| Rate for Payer: Meridian Medicaid |
$1,597.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,481.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,373.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,337.39
|
| Rate for Payer: Nomi Health Commercial |
$7,078.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,474.16
|
| Rate for Payer: PACE Senior Care Partners |
$2,050.15
|
| Rate for Payer: PACE SWMI |
$2,158.05
|
| Rate for Payer: PHP Commercial |
$7,337.39
|
| Rate for Payer: PHP Medicare Advantage |
$2,158.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,521.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,510.03
|
| Rate for Payer: Priority Health Medicare |
$2,179.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,008.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,158.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,596.35
|
| Rate for Payer: UHC Core |
$7,207.90
|
| Rate for Payer: UHC Exchange |
$2,158.05
|
| Rate for Payer: UHC Medicaid |
$1,521.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,158.05
|
| Rate for Payer: UHCCP Medicaid |
$1,521.86
|
| Rate for Payer: VA VA |
$2,158.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,474.16
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,706.50 |
| Max. Negotiated Rate |
$2,206.68 |
| Rate for Payer: Aetna Commercial |
$2,084.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,025.00
|
| Rate for Payer: BCN Commercial |
$2,025.00
|
| Rate for Payer: Cash Price |
$1,961.50
|
| Rate for Payer: Cofinity Commercial |
$2,108.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,961.50
|
| Rate for Payer: Healthscope Commercial |
$2,206.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,838.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,084.09
|
| Rate for Payer: Nomi Health Commercial |
$2,010.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,838.90
|
| Rate for Payer: PHP Commercial |
$2,084.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,133.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,706.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,157.65
|
| Rate for Payer: UHC Core |
$2,047.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,838.90
|
|
