|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,451.87
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.26 |
| Max. Negotiated Rate |
$2,206.68 |
| Rate for Payer: Aetna Commercial |
$2,084.09
|
| Rate for Payer: Aetna Medicare |
$637.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$766.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$766.21
|
| Rate for Payer: BCBS Complete |
$453.84
|
| Rate for Payer: BCBS MAPPO |
$612.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,015.68
|
| Rate for Payer: BCN Commercial |
$2,015.68
|
| Rate for Payer: BCN Medicare Advantage |
$612.97
|
| 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: Health Alliance Plan Medicare Advantage |
$612.97
|
| Rate for Payer: Healthscope Commercial |
$2,206.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,838.90
|
| Rate for Payer: Mclaren Medicaid |
$432.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$643.62
|
| Rate for Payer: Meridian Medicaid |
$453.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$704.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$674.26
|
| 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: PACE Senior Care Partners |
$582.32
|
| Rate for Payer: PACE SWMI |
$612.97
|
| Rate for Payer: PHP Commercial |
$2,084.09
|
| Rate for Payer: PHP Medicare Advantage |
$612.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,133.13
|
| Rate for Payer: Priority Health Medicare |
$619.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,706.50
|
| Rate for Payer: Railroad Medicare Medicare |
$612.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,157.65
|
| Rate for Payer: UHC Core |
$2,047.31
|
| Rate for Payer: UHC Exchange |
$612.97
|
| Rate for Payer: UHC Medicaid |
$432.26
|
| Rate for Payer: UHC Medicare Advantage |
$612.97
|
| Rate for Payer: UHCCP Medicaid |
$432.26
|
| Rate for Payer: VA VA |
$612.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,838.90
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,059.35 |
| Max. Negotiated Rate |
$5,249.16 |
| Rate for Payer: Aetna Commercial |
$4,957.54
|
| Rate for Payer: BCBS Trust/PPO |
$4,816.98
|
| Rate for Payer: BCN Commercial |
$4,816.98
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Commercial |
$5,015.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Healthscope Commercial |
$5,249.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,374.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Nomi Health Commercial |
$4,782.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: PHP Commercial |
$4,957.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,074.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,059.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,132.51
|
| Rate for Payer: UHC Core |
$4,870.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,374.30
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,832.40
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.25 |
| Max. Negotiated Rate |
$5,249.16 |
| Rate for Payer: Aetna Commercial |
$4,957.54
|
| Rate for Payer: Aetna Medicare |
$1,516.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,822.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,822.62
|
| Rate for Payer: BCBS Complete |
$1,079.58
|
| Rate for Payer: BCBS MAPPO |
$1,458.10
|
| Rate for Payer: BCBS Trust/PPO |
$4,794.82
|
| Rate for Payer: BCN Commercial |
$4,794.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,458.10
|
| Rate for Payer: Cash Price |
$4,665.92
|
| Rate for Payer: Cofinity Commercial |
$5,015.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,665.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,458.10
|
| Rate for Payer: Healthscope Commercial |
$5,249.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,374.30
|
| Rate for Payer: Mclaren Medicaid |
$1,028.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,531.01
|
| Rate for Payer: Meridian Medicaid |
$1,079.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,676.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,603.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,957.54
|
| Rate for Payer: Nomi Health Commercial |
$4,782.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,374.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,385.19
|
| Rate for Payer: PACE SWMI |
$1,458.10
|
| Rate for Payer: PHP Commercial |
$4,957.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,458.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,028.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,074.19
|
| Rate for Payer: Priority Health Medicare |
$1,472.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,059.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,458.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,132.51
|
| Rate for Payer: UHC Core |
$4,870.05
|
| Rate for Payer: UHC Exchange |
$1,458.10
|
| Rate for Payer: UHC Medicaid |
$1,028.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,458.10
|
| Rate for Payer: UHCCP Medicaid |
$1,028.25
|
| Rate for Payer: VA VA |
$1,458.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,374.30
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,438.79 |
| Max. Negotiated Rate |
$7,032.92 |
| Rate for Payer: Aetna Commercial |
$6,642.21
|
| Rate for Payer: BCBS Trust/PPO |
$6,453.88
|
| Rate for Payer: BCN Commercial |
$6,453.88
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Commercial |
$6,720.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Healthscope Commercial |
$7,032.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,860.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,642.21
|
| Rate for Payer: Nomi Health Commercial |
$6,407.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| Rate for Payer: PHP Commercial |
$6,642.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,798.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,438.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,876.64
|
| Rate for Payer: UHC Core |
$6,524.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,860.77
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,814.36
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,377.67 |
| Max. Negotiated Rate |
$7,032.92 |
| Rate for Payer: Aetna Commercial |
$6,642.21
|
| Rate for Payer: Aetna Medicare |
$2,031.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,441.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,441.99
|
| Rate for Payer: BCBS Complete |
$1,446.44
|
| Rate for Payer: BCBS MAPPO |
$1,953.59
|
| Rate for Payer: BCBS Trust/PPO |
$6,424.19
|
| Rate for Payer: BCN Commercial |
$6,424.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,953.59
|
| Rate for Payer: Cash Price |
$6,251.49
|
| Rate for Payer: Cofinity Commercial |
$6,720.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,251.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,953.59
|
| Rate for Payer: Healthscope Commercial |
$7,032.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,860.77
|
| Rate for Payer: Mclaren Medicaid |
$1,377.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,051.27
|
| Rate for Payer: Meridian Medicaid |
$1,446.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,246.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,148.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,642.21
|
| Rate for Payer: Nomi Health Commercial |
$6,407.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,860.77
|
| Rate for Payer: PACE Senior Care Partners |
$1,855.91
|
| Rate for Payer: PACE SWMI |
$1,953.59
|
| Rate for Payer: PHP Commercial |
$6,642.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,953.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,377.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,798.49
|
| Rate for Payer: Priority Health Medicare |
$1,973.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,438.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,953.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,876.64
|
| Rate for Payer: UHC Core |
$6,524.99
|
| Rate for Payer: UHC Exchange |
$1,953.59
|
| Rate for Payer: UHC Medicaid |
$1,377.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,953.59
|
| Rate for Payer: UHCCP Medicaid |
$1,377.67
|
| Rate for Payer: VA VA |
$1,953.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,860.77
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,811.98 |
| Max. Negotiated Rate |
$4,929.28 |
| Rate for Payer: Aetna Commercial |
$4,655.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,523.44
|
| Rate for Payer: BCN Commercial |
$4,523.44
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Commercial |
$4,710.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Healthscope Commercial |
$4,929.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,107.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,655.43
|
| Rate for Payer: Nomi Health Commercial |
$4,491.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| Rate for Payer: PHP Commercial |
$4,655.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,764.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,811.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,819.74
|
| Rate for Payer: UHC Core |
$4,573.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,107.73
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,476.98
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$965.59 |
| Max. Negotiated Rate |
$4,929.28 |
| Rate for Payer: Aetna Commercial |
$4,655.43
|
| Rate for Payer: Aetna Medicare |
$1,424.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,711.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,711.56
|
| Rate for Payer: BCBS Complete |
$1,013.79
|
| Rate for Payer: BCBS MAPPO |
$1,369.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,502.63
|
| Rate for Payer: BCN Commercial |
$4,502.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,369.24
|
| Rate for Payer: Cash Price |
$4,381.58
|
| Rate for Payer: Cofinity Commercial |
$4,710.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,381.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,369.24
|
| Rate for Payer: Healthscope Commercial |
$4,929.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,107.73
|
| Rate for Payer: Mclaren Medicaid |
$965.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,437.71
|
| Rate for Payer: Meridian Medicaid |
$1,013.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,574.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,506.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,655.43
|
| Rate for Payer: Nomi Health Commercial |
$4,491.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,107.73
|
| Rate for Payer: PACE Senior Care Partners |
$1,300.78
|
| Rate for Payer: PACE SWMI |
$1,369.24
|
| Rate for Payer: PHP Commercial |
$4,655.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,369.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$965.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,764.97
|
| Rate for Payer: Priority Health Medicare |
$1,382.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,811.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,369.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,819.74
|
| Rate for Payer: UHC Core |
$4,573.28
|
| Rate for Payer: UHC Exchange |
$1,369.24
|
| Rate for Payer: UHC Medicaid |
$965.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,369.24
|
| Rate for Payer: UHCCP Medicaid |
$965.59
|
| Rate for Payer: VA VA |
$1,369.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,107.73
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.41 |
| Max. Negotiated Rate |
$1,650.99 |
| Rate for Payer: Aetna Commercial |
$1,559.27
|
| Rate for Payer: Aetna Medicare |
$476.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$573.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$573.26
|
| Rate for Payer: BCBS Complete |
$339.55
|
| Rate for Payer: BCBS MAPPO |
$458.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,508.08
|
| Rate for Payer: BCN Commercial |
$1,508.08
|
| Rate for Payer: BCN Medicare Advantage |
$458.61
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Commercial |
$1,577.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.61
|
| Rate for Payer: Healthscope Commercial |
$1,650.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,375.82
|
| Rate for Payer: Mclaren Medicaid |
$323.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.54
|
| Rate for Payer: Meridian Medicaid |
$339.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$527.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$504.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Nomi Health Commercial |
$1,504.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: PACE Senior Care Partners |
$435.68
|
| Rate for Payer: PACE SWMI |
$458.61
|
| Rate for Payer: PHP Commercial |
$1,559.27
|
| Rate for Payer: PHP Medicare Advantage |
$458.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,595.95
|
| Rate for Payer: Priority Health Medicare |
$463.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,276.76
|
| Rate for Payer: Railroad Medicare Medicare |
$458.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.30
|
| Rate for Payer: UHC Core |
$1,531.75
|
| Rate for Payer: UHC Exchange |
$458.61
|
| Rate for Payer: UHC Medicaid |
$323.41
|
| Rate for Payer: UHC Medicare Advantage |
$458.61
|
| Rate for Payer: UHCCP Medicaid |
$323.41
|
| Rate for Payer: VA VA |
$458.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,375.82
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,834.43
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,276.76 |
| Max. Negotiated Rate |
$1,650.99 |
| Rate for Payer: Aetna Commercial |
$1,559.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.06
|
| Rate for Payer: BCN Commercial |
$1,515.06
|
| Rate for Payer: Cash Price |
$1,467.54
|
| Rate for Payer: Cofinity Commercial |
$1,577.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.54
|
| Rate for Payer: Healthscope Commercial |
$1,650.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,375.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.27
|
| Rate for Payer: Nomi Health Commercial |
$1,504.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,375.82
|
| Rate for Payer: PHP Commercial |
$1,559.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,595.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,276.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.30
|
| Rate for Payer: UHC Core |
$1,531.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,375.82
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.67 |
| Max. Negotiated Rate |
$1,994.34 |
| Rate for Payer: Aetna Commercial |
$1,883.54
|
| Rate for Payer: Aetna Medicare |
$576.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$692.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$692.48
|
| Rate for Payer: BCBS Complete |
$410.17
|
| Rate for Payer: BCBS MAPPO |
$553.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,821.72
|
| Rate for Payer: BCN Commercial |
$1,821.72
|
| Rate for Payer: BCN Medicare Advantage |
$553.98
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Commercial |
$1,905.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$553.98
|
| Rate for Payer: Healthscope Commercial |
$1,994.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,661.95
|
| Rate for Payer: Mclaren Medicaid |
$390.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$581.68
|
| Rate for Payer: Meridian Medicaid |
$410.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$637.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$609.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,883.54
|
| Rate for Payer: Nomi Health Commercial |
$1,817.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: PACE Senior Care Partners |
$526.28
|
| Rate for Payer: PACE SWMI |
$553.98
|
| Rate for Payer: PHP Commercial |
$1,883.54
|
| Rate for Payer: PHP Medicare Advantage |
$553.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$390.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,927.86
|
| Rate for Payer: Priority Health Medicare |
$559.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.29
|
| Rate for Payer: Railroad Medicare Medicare |
$553.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.02
|
| Rate for Payer: UHC Core |
$1,850.30
|
| Rate for Payer: UHC Exchange |
$553.98
|
| Rate for Payer: UHC Medicaid |
$390.67
|
| Rate for Payer: UHC Medicare Advantage |
$553.98
|
| Rate for Payer: UHCCP Medicaid |
$390.67
|
| Rate for Payer: VA VA |
$553.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,661.95
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,215.93
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,542.29 |
| Max. Negotiated Rate |
$1,994.34 |
| Rate for Payer: Aetna Commercial |
$1,883.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,830.14
|
| Rate for Payer: BCN Commercial |
$1,830.14
|
| Rate for Payer: Cash Price |
$1,772.74
|
| Rate for Payer: Cofinity Commercial |
$1,905.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,772.74
|
| Rate for Payer: Healthscope Commercial |
$1,994.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,661.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,883.54
|
| Rate for Payer: Nomi Health Commercial |
$1,817.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,661.95
|
| Rate for Payer: PHP Commercial |
$1,883.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,927.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,542.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,950.02
|
| Rate for Payer: UHC Core |
$1,850.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,661.95
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$329.00 |
| Max. Negotiated Rate |
$425.43 |
| Rate for Payer: Aetna Commercial |
$401.80
|
| Rate for Payer: BCBS Trust/PPO |
$390.40
|
| Rate for Payer: BCN Commercial |
$390.40
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Commercial |
$406.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Healthscope Commercial |
$425.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Nomi Health Commercial |
$387.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: PHP Commercial |
$401.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.98
|
| Rate for Payer: UHC Core |
$394.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.52
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$472.70
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$425.43 |
| Rate for Payer: Aetna Commercial |
$401.80
|
| Rate for Payer: Aetna Medicare |
$122.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.72
|
| Rate for Payer: BCBS Complete |
$87.50
|
| Rate for Payer: BCBS MAPPO |
$118.17
|
| Rate for Payer: BCBS Trust/PPO |
$388.61
|
| Rate for Payer: BCN Commercial |
$388.61
|
| Rate for Payer: BCN Medicare Advantage |
$118.17
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cofinity Commercial |
$406.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.17
|
| Rate for Payer: Healthscope Commercial |
$425.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.52
|
| Rate for Payer: Mclaren Medicaid |
$83.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.08
|
| Rate for Payer: Meridian Medicaid |
$87.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.80
|
| Rate for Payer: Nomi Health Commercial |
$387.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.52
|
| Rate for Payer: PACE Senior Care Partners |
$112.27
|
| Rate for Payer: PACE SWMI |
$118.17
|
| Rate for Payer: PHP Commercial |
$401.80
|
| Rate for Payer: PHP Medicare Advantage |
$118.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.25
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.00
|
| Rate for Payer: Railroad Medicare Medicare |
$118.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.98
|
| Rate for Payer: UHC Core |
$394.70
|
| Rate for Payer: UHC Exchange |
$118.17
|
| Rate for Payer: UHC Medicaid |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$118.17
|
| Rate for Payer: UHCCP Medicaid |
$83.34
|
| Rate for Payer: VA VA |
$118.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.52
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.07
|
| Rate for Payer: BCN Commercial |
$301.07
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.92
|
| Rate for Payer: BCBS Complete |
$67.47
|
| Rate for Payer: BCBS MAPPO |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$299.68
|
| Rate for Payer: BCN Commercial |
$299.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.13
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.13
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.69
|
| Rate for Payer: Meridian Medicaid |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.58
|
| Rate for Payer: PACE SWMI |
$91.13
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$91.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: Railroad Medicare Medicare |
$91.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: UHC Exchange |
$91.13
|
| Rate for Payer: UHC Medicaid |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$91.13
|
| Rate for Payer: UHCCP Medicaid |
$64.27
|
| Rate for Payer: VA VA |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.15 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: BCBS Trust/PPO |
$413.12
|
| Rate for Payer: BCN Commercial |
$413.12
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.18
|
| Rate for Payer: UHC Core |
$417.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$500.21
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.19 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna Medicare |
$130.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.32
|
| Rate for Payer: BCBS Complete |
$92.59
|
| Rate for Payer: BCBS MAPPO |
$125.05
|
| Rate for Payer: BCBS Trust/PPO |
$411.22
|
| Rate for Payer: BCN Commercial |
$411.22
|
| Rate for Payer: BCN Medicare Advantage |
$125.05
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.05
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Mclaren Medicaid |
$88.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.31
|
| Rate for Payer: Meridian Medicaid |
$92.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$410.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PACE Senior Care Partners |
$118.80
|
| Rate for Payer: PACE SWMI |
$125.05
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: PHP Medicare Advantage |
$125.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.18
|
| Rate for Payer: Priority Health Medicare |
$126.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.15
|
| Rate for Payer: Railroad Medicare Medicare |
$125.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.18
|
| Rate for Payer: UHC Core |
$417.68
|
| Rate for Payer: UHC Exchange |
$125.05
|
| Rate for Payer: UHC Medicaid |
$88.19
|
| Rate for Payer: UHC Medicare Advantage |
$125.05
|
| Rate for Payer: UHCCP Medicaid |
$88.19
|
| Rate for Payer: VA VA |
$125.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,145.14
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$201.89 |
| Max. Negotiated Rate |
$1,030.63 |
| Rate for Payer: Aetna Commercial |
$973.37
|
| Rate for Payer: Aetna Medicare |
$297.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.86
|
| Rate for Payer: BCBS Complete |
$211.97
|
| Rate for Payer: BCBS MAPPO |
$286.29
|
| Rate for Payer: BCBS Trust/PPO |
$941.42
|
| Rate for Payer: BCN Commercial |
$941.42
|
| Rate for Payer: BCN Medicare Advantage |
$286.29
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$984.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.29
|
| Rate for Payer: Healthscope Commercial |
$1,030.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.86
|
| Rate for Payer: Mclaren Medicaid |
$201.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.60
|
| Rate for Payer: Meridian Medicaid |
$211.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PACE Senior Care Partners |
$271.97
|
| Rate for Payer: PACE SWMI |
$286.29
|
| Rate for Payer: PHP Commercial |
$973.37
|
| Rate for Payer: PHP Medicare Advantage |
$286.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.27
|
| Rate for Payer: Priority Health Medicare |
$289.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.02
|
| Rate for Payer: Railroad Medicare Medicare |
$286.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.72
|
| Rate for Payer: UHC Core |
$956.19
|
| Rate for Payer: UHC Exchange |
$286.29
|
| Rate for Payer: UHC Medicaid |
$201.89
|
| Rate for Payer: UHC Medicare Advantage |
$286.29
|
| Rate for Payer: UHCCP Medicaid |
$201.89
|
| Rate for Payer: VA VA |
$286.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.86
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,145.14
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$797.02 |
| Max. Negotiated Rate |
$1,030.63 |
| Rate for Payer: Aetna Commercial |
$973.37
|
| Rate for Payer: BCBS Trust/PPO |
$945.77
|
| Rate for Payer: BCN Commercial |
$945.77
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$984.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PHP Commercial |
$973.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.72
|
| Rate for Payer: UHC Core |
$956.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.86
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,457.43
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,014.37 |
| Max. Negotiated Rate |
$1,311.69 |
| Rate for Payer: Aetna Commercial |
$1,238.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.69
|
| Rate for Payer: BCN Commercial |
$1,203.69
|
| Rate for Payer: Cash Price |
$1,165.94
|
| Rate for Payer: Cofinity Commercial |
$1,253.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.94
|
| Rate for Payer: Healthscope Commercial |
$1,311.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,238.82
|
| Rate for Payer: Nomi Health Commercial |
$1,195.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.07
|
| Rate for Payer: PHP Commercial |
$1,238.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,267.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,282.54
|
| Rate for Payer: UHC Core |
$1,216.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.07
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,457.43
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$256.94 |
| Max. Negotiated Rate |
$1,311.69 |
| Rate for Payer: Aetna Commercial |
$1,238.82
|
| Rate for Payer: Aetna Medicare |
$378.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$455.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$455.45
|
| Rate for Payer: BCBS Complete |
$269.77
|
| Rate for Payer: BCBS MAPPO |
$364.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.15
|
| Rate for Payer: BCN Commercial |
$1,198.15
|
| Rate for Payer: BCN Medicare Advantage |
$364.36
|
| Rate for Payer: Cash Price |
$1,165.94
|
| Rate for Payer: Cofinity Commercial |
$1,253.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,165.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.36
|
| Rate for Payer: Healthscope Commercial |
$1,311.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.07
|
| Rate for Payer: Mclaren Medicaid |
$256.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.58
|
| Rate for Payer: Meridian Medicaid |
$269.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$419.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,238.82
|
| Rate for Payer: Nomi Health Commercial |
$1,195.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.07
|
| Rate for Payer: PACE Senior Care Partners |
$346.14
|
| Rate for Payer: PACE SWMI |
$364.36
|
| Rate for Payer: PHP Commercial |
$1,238.82
|
| Rate for Payer: PHP Medicare Advantage |
$364.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,267.96
|
| Rate for Payer: Priority Health Medicare |
$368.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.37
|
| Rate for Payer: Railroad Medicare Medicare |
$364.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,282.54
|
| Rate for Payer: UHC Core |
$1,216.95
|
| Rate for Payer: UHC Exchange |
$364.36
|
| Rate for Payer: UHC Medicaid |
$256.94
|
| Rate for Payer: UHC Medicare Advantage |
$364.36
|
| Rate for Payer: UHCCP Medicaid |
$256.94
|
| Rate for Payer: VA VA |
$364.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.07
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,877.70
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,877.70
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,641.57
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,534.53 |
| Max. Negotiated Rate |
$3,277.41 |
| Rate for Payer: Aetna Commercial |
$3,095.33
|
| Rate for Payer: BCBS Trust/PPO |
$3,007.57
|
| Rate for Payer: BCN Commercial |
$3,007.57
|
| Rate for Payer: Cash Price |
$2,913.26
|
| Rate for Payer: Cofinity Commercial |
$3,131.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.26
|
| Rate for Payer: Healthscope Commercial |
$3,277.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.33
|
| Rate for Payer: Nomi Health Commercial |
$2,986.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.18
|
| Rate for Payer: PHP Commercial |
$3,095.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,168.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,534.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,204.58
|
| Rate for Payer: UHC Core |
$3,040.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.18
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,641.57
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$642.01 |
| Max. Negotiated Rate |
$3,277.41 |
| Rate for Payer: Aetna Commercial |
$3,095.33
|
| Rate for Payer: Aetna Medicare |
$946.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,137.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,137.99
|
| Rate for Payer: BCBS Complete |
$674.05
|
| Rate for Payer: BCBS MAPPO |
$910.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,993.73
|
| Rate for Payer: BCN Commercial |
$2,993.73
|
| Rate for Payer: BCN Medicare Advantage |
$910.39
|
| Rate for Payer: Cash Price |
$2,913.26
|
| Rate for Payer: Cofinity Commercial |
$3,131.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.39
|
| Rate for Payer: Healthscope Commercial |
$3,277.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.18
|
| Rate for Payer: Mclaren Medicaid |
$642.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.91
|
| Rate for Payer: Meridian Medicaid |
$674.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,046.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,001.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.33
|
| Rate for Payer: Nomi Health Commercial |
$2,986.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.18
|
| Rate for Payer: PACE Senior Care Partners |
$864.87
|
| Rate for Payer: PACE SWMI |
$910.39
|
| Rate for Payer: PHP Commercial |
$3,095.33
|
| Rate for Payer: PHP Medicare Advantage |
$910.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$642.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,168.17
|
| Rate for Payer: Priority Health Medicare |
$919.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,534.53
|
| Rate for Payer: Railroad Medicare Medicare |
$910.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,204.58
|
| Rate for Payer: UHC Core |
$3,040.71
|
| Rate for Payer: UHC Exchange |
$910.39
|
| Rate for Payer: UHC Medicaid |
$642.01
|
| Rate for Payer: UHC Medicare Advantage |
$910.39
|
| Rate for Payer: UHCCP Medicaid |
$642.01
|
| Rate for Payer: VA VA |
$910.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.18
|
|
