|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,134.11
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,169.35 |
| Max. Negotiated Rate |
$8,220.70 |
| Rate for Payer: Aetna Commercial |
$7,763.99
|
| Rate for Payer: Aetna Medicare |
$2,374.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,854.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,854.41
|
| Rate for Payer: BCBS Complete |
$3,653.64
|
| Rate for Payer: BCBS MAPPO |
$2,283.53
|
| Rate for Payer: BCBS Trust/PPO |
$7,101.77
|
| Rate for Payer: BCN Commercial |
$7,101.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,283.53
|
| Rate for Payer: Cash Price |
$7,307.29
|
| Rate for Payer: Cofinity Commercial |
$7,855.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,307.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,283.53
|
| Rate for Payer: Healthscope Commercial |
$8,220.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,850.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,397.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,626.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,763.99
|
| Rate for Payer: PACE Senior Care Partners |
$2,169.35
|
| Rate for Payer: PACE SWMI |
$2,283.53
|
| Rate for Payer: PHP Commercial |
$7,763.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,283.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,393.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,946.68
|
| Rate for Payer: Priority Health Medicare |
$2,283.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,570.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,283.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,038.02
|
| Rate for Payer: UHC Core |
$7,626.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,283.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,352.03
|
| Rate for Payer: VA VA |
$2,283.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,850.58
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,187.64
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,557.06 |
| Max. Negotiated Rate |
$17,268.88 |
| Rate for Payer: Aetna Commercial |
$16,309.49
|
| Rate for Payer: Aetna Medicare |
$4,988.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,996.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,996.14
|
| Rate for Payer: BCBS Complete |
$7,675.06
|
| Rate for Payer: BCBS MAPPO |
$4,796.91
|
| Rate for Payer: BCBS Trust/PPO |
$14,918.39
|
| Rate for Payer: BCN Commercial |
$14,918.39
|
| Rate for Payer: BCN Medicare Advantage |
$4,796.91
|
| Rate for Payer: Cash Price |
$15,350.11
|
| Rate for Payer: Cofinity Commercial |
$16,501.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,350.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,796.91
|
| Rate for Payer: Healthscope Commercial |
$17,268.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,390.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,036.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,516.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,309.49
|
| Rate for Payer: PACE Senior Care Partners |
$4,557.06
|
| Rate for Payer: PACE SWMI |
$4,796.91
|
| Rate for Payer: PHP Commercial |
$16,309.49
|
| Rate for Payer: PHP Medicare Advantage |
$4,796.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,431.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,693.25
|
| Rate for Payer: Priority Health Medicare |
$4,796.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,702.54
|
| Rate for Payer: Railroad Medicare Medicare |
$4,796.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,885.12
|
| Rate for Payer: UHC Core |
$16,021.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,796.91
|
| Rate for Payer: UHC Medicare Advantage |
$4,940.82
|
| Rate for Payer: VA VA |
$4,796.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,390.73
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,187.64
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,702.54 |
| Max. Negotiated Rate |
$17,268.88 |
| Rate for Payer: Aetna Commercial |
$16,309.49
|
| Rate for Payer: BCBS Trust/PPO |
$14,828.21
|
| Rate for Payer: BCN Commercial |
$14,828.21
|
| Rate for Payer: Cash Price |
$15,350.11
|
| Rate for Payer: Cofinity Commercial |
$16,501.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,350.11
|
| Rate for Payer: Healthscope Commercial |
$17,268.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,390.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,309.49
|
| Rate for Payer: PHP Commercial |
$16,309.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,431.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,693.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,702.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,885.12
|
| Rate for Payer: UHC Core |
$16,021.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,390.73
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
IP
|
$465.72
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$284.04 |
| Max. Negotiated Rate |
$419.15 |
| Rate for Payer: Aetna Commercial |
$395.86
|
| Rate for Payer: BCBS Trust/PPO |
$359.91
|
| Rate for Payer: BCN Commercial |
$359.91
|
| Rate for Payer: Cash Price |
$372.58
|
| Rate for Payer: Cofinity Commercial |
$400.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.58
|
| Rate for Payer: Healthscope Commercial |
$419.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$395.86
|
| Rate for Payer: PHP Commercial |
$395.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.83
|
| Rate for Payer: UHC Core |
$388.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.29
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
OP
|
$465.72
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$110.61 |
| Max. Negotiated Rate |
$419.15 |
| Rate for Payer: Aetna Commercial |
$395.86
|
| Rate for Payer: Aetna Medicare |
$121.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.54
|
| Rate for Payer: BCBS Complete |
$186.29
|
| Rate for Payer: BCBS MAPPO |
$116.43
|
| Rate for Payer: BCBS Trust/PPO |
$362.10
|
| Rate for Payer: BCN Commercial |
$362.10
|
| Rate for Payer: BCN Medicare Advantage |
$116.43
|
| Rate for Payer: Cash Price |
$372.58
|
| Rate for Payer: Cofinity Commercial |
$400.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.43
|
| Rate for Payer: Healthscope Commercial |
$419.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$395.86
|
| Rate for Payer: PACE Senior Care Partners |
$110.61
|
| Rate for Payer: PACE SWMI |
$116.43
|
| Rate for Payer: PHP Commercial |
$395.86
|
| Rate for Payer: PHP Medicare Advantage |
$116.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.18
|
| Rate for Payer: Priority Health Medicare |
$116.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.04
|
| Rate for Payer: Railroad Medicare Medicare |
$116.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.83
|
| Rate for Payer: UHC Core |
$388.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.43
|
| Rate for Payer: UHC Medicare Advantage |
$119.92
|
| Rate for Payer: VA VA |
$116.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.29
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$21.40
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$19.26 |
| Rate for Payer: Aetna Commercial |
$18.19
|
| Rate for Payer: Aetna Medicare |
$5.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$4.26
|
| Rate for Payer: BCBS MAPPO |
$5.35
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$5.35
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.35
|
| Rate for Payer: Healthscope Commercial |
$19.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.05
|
| Rate for Payer: Mclaren Medicaid |
$4.06
|
| Rate for Payer: Meridian Medicaid |
$4.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.19
|
| Rate for Payer: PACE Senior Care Partners |
$5.08
|
| Rate for Payer: PACE SWMI |
$5.35
|
| Rate for Payer: PHP Commercial |
$18.19
|
| Rate for Payer: PHP Medicare Advantage |
$5.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.62
|
| Rate for Payer: Priority Health Medicare |
$5.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.83
|
| Rate for Payer: UHC Core |
$17.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.35
|
| Rate for Payer: UHC Medicare Advantage |
$5.51
|
| Rate for Payer: VA VA |
$5.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.05
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$21.40
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$19.26 |
| Rate for Payer: Aetna Commercial |
$18.19
|
| Rate for Payer: BCBS Trust/PPO |
$16.54
|
| Rate for Payer: BCN Commercial |
$16.54
|
| Rate for Payer: Cash Price |
$17.12
|
| Rate for Payer: Cofinity Commercial |
$18.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$19.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.19
|
| Rate for Payer: PHP Commercial |
$18.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.83
|
| Rate for Payer: UHC Core |
$17.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.05
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$857.57 |
| Max. Negotiated Rate |
$5,211.10 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna Medicare |
$938.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,128.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,128.38
|
| Rate for Payer: BCBS Complete |
$5,211.10
|
| Rate for Payer: BCBS MAPPO |
$902.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.41
|
| Rate for Payer: BCN Commercial |
$2,807.41
|
| Rate for Payer: BCN Medicare Advantage |
$902.70
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.70
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Mclaren Medicaid |
$4,962.95
|
| Rate for Payer: Meridian Medicaid |
$5,211.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$947.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,038.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Senior Care Partners |
$857.57
|
| Rate for Payer: PACE SWMI |
$902.70
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: PHP Medicare Advantage |
$902.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,962.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Medicare |
$902.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: Railroad Medicare Medicare |
$902.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.70
|
| Rate for Payer: UHC Medicare Advantage |
$929.79
|
| Rate for Payer: VA VA |
$902.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,202.24 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,790.44
|
| Rate for Payer: BCN Commercial |
$2,790.44
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$857.57 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna Medicare |
$938.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,128.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,128.38
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$902.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.41
|
| Rate for Payer: BCN Commercial |
$2,807.41
|
| Rate for Payer: BCN Medicare Advantage |
$902.70
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.70
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$947.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,038.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Senior Care Partners |
$857.57
|
| Rate for Payer: PACE SWMI |
$902.70
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: PHP Medicare Advantage |
$902.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Medicare |
$902.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: Railroad Medicare Medicare |
$902.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.70
|
| Rate for Payer: UHC Medicare Advantage |
$929.79
|
| Rate for Payer: VA VA |
$902.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,202.24 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,790.44
|
| Rate for Payer: BCN Commercial |
$2,790.44
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,902.38 |
| Max. Negotiated Rate |
$2,807.24 |
| Rate for Payer: Aetna Commercial |
$2,651.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,410.49
|
| Rate for Payer: BCN Commercial |
$2,410.49
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,682.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Healthscope Commercial |
$2,807.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,339.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: PHP Commercial |
$2,651.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,713.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,902.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,744.86
|
| Rate for Payer: UHC Core |
$2,604.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,339.37
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$740.80 |
| Max. Negotiated Rate |
$2,807.24 |
| Rate for Payer: Aetna Commercial |
$2,651.29
|
| Rate for Payer: Aetna Medicare |
$810.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$974.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$974.74
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$779.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.15
|
| Rate for Payer: BCN Commercial |
$2,425.15
|
| Rate for Payer: BCN Medicare Advantage |
$779.79
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,682.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.79
|
| Rate for Payer: Healthscope Commercial |
$2,807.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,339.37
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$896.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: PACE Senior Care Partners |
$740.80
|
| Rate for Payer: PACE SWMI |
$779.79
|
| Rate for Payer: PHP Commercial |
$2,651.29
|
| Rate for Payer: PHP Medicare Advantage |
$779.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,713.67
|
| Rate for Payer: Priority Health Medicare |
$779.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,902.38
|
| Rate for Payer: Railroad Medicare Medicare |
$779.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,744.86
|
| Rate for Payer: UHC Core |
$2,604.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.79
|
| Rate for Payer: UHC Medicare Advantage |
$803.18
|
| Rate for Payer: VA VA |
$779.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,339.37
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.02 |
| Max. Negotiated Rate |
$1,028.56 |
| Rate for Payer: Aetna Commercial |
$971.42
|
| Rate for Payer: BCBS Trust/PPO |
$883.19
|
| Rate for Payer: BCN Commercial |
$883.19
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$982.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Healthscope Commercial |
$1,028.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: PHP Commercial |
$971.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$994.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$697.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.71
|
| Rate for Payer: UHC Core |
$954.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.14
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$176.03 |
| Max. Negotiated Rate |
$1,028.56 |
| Rate for Payer: Aetna Commercial |
$971.42
|
| Rate for Payer: Aetna Medicare |
$297.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.14
|
| Rate for Payer: BCBS Complete |
$457.14
|
| Rate for Payer: BCBS MAPPO |
$285.71
|
| Rate for Payer: BCBS Trust/PPO |
$888.57
|
| Rate for Payer: BCCCP Commercial |
$176.03
|
| Rate for Payer: BCN Commercial |
$888.57
|
| Rate for Payer: BCN Medicare Advantage |
$285.71
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$982.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.71
|
| Rate for Payer: Healthscope Commercial |
$1,028.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: PACE Senior Care Partners |
$271.43
|
| Rate for Payer: PACE SWMI |
$285.71
|
| Rate for Payer: PHP Commercial |
$971.42
|
| Rate for Payer: PHP Medicare Advantage |
$285.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$994.28
|
| Rate for Payer: Priority Health Medicare |
$285.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$697.02
|
| Rate for Payer: Railroad Medicare Medicare |
$285.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.71
|
| Rate for Payer: UHC Core |
$954.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.71
|
| Rate for Payer: UHC Medicare Advantage |
$294.28
|
| Rate for Payer: VA VA |
$285.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.14
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,049.97 |
| Max. Negotiated Rate |
$1,549.40 |
| Rate for Payer: Aetna Commercial |
$1,463.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.41
|
| Rate for Payer: BCN Commercial |
$1,330.41
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,480.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Healthscope Commercial |
$1,549.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: PHP Commercial |
$1,463.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,049.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,514.96
|
| Rate for Payer: UHC Core |
$1,437.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.16
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.87 |
| Max. Negotiated Rate |
$1,549.40 |
| Rate for Payer: Aetna Commercial |
$1,463.32
|
| Rate for Payer: Aetna Medicare |
$447.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$537.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$537.98
|
| Rate for Payer: BCBS Complete |
$688.62
|
| Rate for Payer: BCBS MAPPO |
$430.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,338.51
|
| Rate for Payer: BCCCP Commercial |
$506.78
|
| Rate for Payer: BCN Commercial |
$1,338.51
|
| Rate for Payer: BCN Medicare Advantage |
$430.39
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,480.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.39
|
| Rate for Payer: Healthscope Commercial |
$1,549.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$451.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$494.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: PACE Senior Care Partners |
$408.87
|
| Rate for Payer: PACE SWMI |
$430.39
|
| Rate for Payer: PHP Commercial |
$1,463.32
|
| Rate for Payer: PHP Medicare Advantage |
$430.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,497.75
|
| Rate for Payer: Priority Health Medicare |
$430.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,049.97
|
| Rate for Payer: Railroad Medicare Medicare |
$430.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,514.96
|
| Rate for Payer: UHC Core |
$1,437.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.39
|
| Rate for Payer: UHC Medicare Advantage |
$443.30
|
| Rate for Payer: VA VA |
$430.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.16
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,259.91 |
| Max. Negotiated Rate |
$1,859.18 |
| Rate for Payer: Aetna Commercial |
$1,755.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.42
|
| Rate for Payer: BCN Commercial |
$1,596.42
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,776.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Healthscope Commercial |
$1,859.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: PHP Commercial |
$1,755.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,259.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,817.87
|
| Rate for Payer: UHC Core |
$1,724.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.32
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.10 |
| Max. Negotiated Rate |
$1,859.18 |
| Rate for Payer: Aetna Commercial |
$1,755.90
|
| Rate for Payer: Aetna Medicare |
$537.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$645.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$645.55
|
| Rate for Payer: BCBS Complete |
$826.30
|
| Rate for Payer: BCBS MAPPO |
$516.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.13
|
| Rate for Payer: BCCCP Commercial |
$197.10
|
| Rate for Payer: BCN Commercial |
$1,606.13
|
| Rate for Payer: BCN Medicare Advantage |
$516.44
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,776.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.44
|
| Rate for Payer: Healthscope Commercial |
$1,859.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$593.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: PACE Senior Care Partners |
$490.62
|
| Rate for Payer: PACE SWMI |
$516.44
|
| Rate for Payer: PHP Commercial |
$1,755.90
|
| Rate for Payer: PHP Medicare Advantage |
$516.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.21
|
| Rate for Payer: Priority Health Medicare |
$516.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,259.91
|
| Rate for Payer: Railroad Medicare Medicare |
$516.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,817.87
|
| Rate for Payer: UHC Core |
$1,724.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.44
|
| Rate for Payer: UHC Medicare Advantage |
$531.93
|
| Rate for Payer: VA VA |
$516.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.32
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,745.20 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna Commercial |
$2,432.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,211.33
|
| Rate for Payer: BCN Commercial |
$2,211.33
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,460.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Healthscope Commercial |
$2,575.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: PHP Commercial |
$2,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,489.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,745.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,518.08
|
| Rate for Payer: UHC Core |
$2,389.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.09
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.47 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna Commercial |
$2,432.23
|
| Rate for Payer: Aetna Medicare |
$743.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$894.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$894.20
|
| Rate for Payer: BCBS Complete |
$1,144.58
|
| Rate for Payer: BCBS MAPPO |
$715.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.78
|
| Rate for Payer: BCCCP Commercial |
$312.47
|
| Rate for Payer: BCN Commercial |
$2,224.78
|
| Rate for Payer: BCN Medicare Advantage |
$715.36
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,460.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.36
|
| Rate for Payer: Healthscope Commercial |
$2,575.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$751.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$822.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: PACE Senior Care Partners |
$679.59
|
| Rate for Payer: PACE SWMI |
$715.36
|
| Rate for Payer: PHP Commercial |
$2,432.23
|
| Rate for Payer: PHP Medicare Advantage |
$715.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,489.46
|
| Rate for Payer: Priority Health Medicare |
$715.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,745.20
|
| Rate for Payer: Railroad Medicare Medicare |
$715.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,518.08
|
| Rate for Payer: UHC Core |
$2,389.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.36
|
| Rate for Payer: UHC Medicare Advantage |
$736.82
|
| Rate for Payer: VA VA |
$715.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.09
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$866.29 |
| Max. Negotiated Rate |
$1,278.34 |
| Rate for Payer: Aetna Commercial |
$1,207.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.67
|
| Rate for Payer: BCN Commercial |
$1,097.67
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,221.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Healthscope Commercial |
$1,278.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: PHP Commercial |
$1,207.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,235.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,249.93
|
| Rate for Payer: UHC Core |
$1,186.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.28
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.73 |
| Max. Negotiated Rate |
$1,278.34 |
| Rate for Payer: Aetna Commercial |
$1,207.32
|
| Rate for Payer: Aetna Medicare |
$369.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.87
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$355.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.35
|
| Rate for Payer: BCCCP Commercial |
$248.73
|
| Rate for Payer: BCN Commercial |
$1,104.35
|
| Rate for Payer: BCN Medicare Advantage |
$355.10
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,221.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.10
|
| Rate for Payer: Healthscope Commercial |
$1,278.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.28
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: PACE Senior Care Partners |
$337.34
|
| Rate for Payer: PACE SWMI |
$355.10
|
| Rate for Payer: PHP Commercial |
$1,207.32
|
| Rate for Payer: PHP Medicare Advantage |
$355.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,235.73
|
| Rate for Payer: Priority Health Medicare |
$355.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.29
|
| Rate for Payer: Railroad Medicare Medicare |
$355.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,249.93
|
| Rate for Payer: UHC Core |
$1,186.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.10
|
| Rate for Payer: UHC Medicare Advantage |
$365.75
|
| Rate for Payer: VA VA |
$355.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.28
|
|
