|
HC INFRARED THERAPY
|
Facility
|
OP
|
$58.63
|
|
|
Service Code
|
CPT 97026
|
| Hospital Charge Code |
42000013
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: Aetna Medicare |
$15.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.32
|
| Rate for Payer: BCBS Complete |
$23.45
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$45.58
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: PACE Senior Care Partners |
$13.92
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.11
|
| Rate for Payer: Priority Health HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Medicare |
$14.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.28
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.66
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC INFRARED THERAPY
|
Facility
|
IP
|
$58.63
|
|
|
Service Code
|
CPT 97026
|
| Hospital Charge Code |
42000013
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$38.11 |
| Max. Negotiated Rate |
$52.77 |
| Rate for Payer: Aetna Commercial |
$49.84
|
| Rate for Payer: BCBS Trust/PPO |
$47.86
|
| Rate for Payer: BCN Commercial |
$45.31
|
| Rate for Payer: Cash Price |
$46.90
|
| Rate for Payer: Cofinity Commercial |
$50.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.90
|
| Rate for Payer: Healthscope Commercial |
$52.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.84
|
| Rate for Payer: Nomi Health Commercial |
$48.08
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.11
|
| Rate for Payer: Priority Health HMO/PPO |
$51.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.59
|
| Rate for Payer: UHC Core |
$48.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.97
|
|
|
HC INFUSION CATHETER LVL 1
|
Facility
|
IP
|
$160.65
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.42 |
| Max. Negotiated Rate |
$144.58 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: BCBS Trust/PPO |
$131.14
|
| Rate for Payer: BCN Commercial |
$124.15
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$144.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC INFUSION CATHETER LVL 1
|
Facility
|
OP
|
$160.65
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$144.58 |
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.20
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: BCBS MAPPO |
$40.16
|
| Rate for Payer: BCBS Trust/PPO |
$132.07
|
| Rate for Payer: BCN Commercial |
$124.91
|
| Rate for Payer: BCN Medicare Advantage |
$40.16
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.16
|
| Rate for Payer: Healthscope Commercial |
$144.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: Nomi Health Commercial |
$131.73
|
| Rate for Payer: PACE Senior Care Partners |
$38.15
|
| Rate for Payer: PACE SWMI |
$40.16
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health HMO/PPO |
$139.77
|
| Rate for Payer: Priority Health Medicare |
$40.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.64
|
| Rate for Payer: Railroad Medicare Medicare |
$40.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.37
|
| Rate for Payer: UHC Core |
$134.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.16
|
| Rate for Payer: UHC Exchange |
$40.16
|
| Rate for Payer: UHC Medicare Advantage |
$40.16
|
| Rate for Payer: VA VA |
$40.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC INFUSION CATHETER LVL 2
|
Facility
|
IP
|
$241.86
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$157.21 |
| Max. Negotiated Rate |
$217.67 |
| Rate for Payer: Aetna Commercial |
$205.58
|
| Rate for Payer: BCBS Trust/PPO |
$197.43
|
| Rate for Payer: BCN Commercial |
$186.91
|
| Rate for Payer: Cash Price |
$193.49
|
| Rate for Payer: Cofinity Commercial |
$208.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.49
|
| Rate for Payer: Healthscope Commercial |
$217.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.58
|
| Rate for Payer: Nomi Health Commercial |
$198.33
|
| Rate for Payer: PHP Commercial |
$205.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.21
|
| Rate for Payer: Priority Health HMO/PPO |
$210.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.84
|
| Rate for Payer: UHC Core |
$201.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.40
|
|
|
HC INFUSION CATHETER LVL 2
|
Facility
|
OP
|
$241.86
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.44 |
| Max. Negotiated Rate |
$217.67 |
| Rate for Payer: Aetna Commercial |
$205.58
|
| Rate for Payer: Aetna Medicare |
$62.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.58
|
| Rate for Payer: BCBS Complete |
$96.74
|
| Rate for Payer: BCBS MAPPO |
$60.46
|
| Rate for Payer: BCBS Trust/PPO |
$198.83
|
| Rate for Payer: BCN Commercial |
$188.05
|
| Rate for Payer: BCN Medicare Advantage |
$60.46
|
| Rate for Payer: Cash Price |
$193.49
|
| Rate for Payer: Cofinity Commercial |
$208.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.46
|
| Rate for Payer: Healthscope Commercial |
$217.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.58
|
| Rate for Payer: Nomi Health Commercial |
$198.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.44
|
| Rate for Payer: PACE SWMI |
$60.46
|
| Rate for Payer: PHP Commercial |
$205.58
|
| Rate for Payer: PHP Medicare Advantage |
$60.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.21
|
| Rate for Payer: Priority Health HMO/PPO |
$210.42
|
| Rate for Payer: Priority Health Medicare |
$61.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.05
|
| Rate for Payer: Railroad Medicare Medicare |
$60.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.84
|
| Rate for Payer: UHC Core |
$201.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.46
|
| Rate for Payer: UHC Exchange |
$60.46
|
| Rate for Payer: UHC Medicare Advantage |
$60.46
|
| Rate for Payer: VA VA |
$60.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.40
|
|
|
HC INFUSION CATHETER LVL 3
|
Facility
|
OP
|
$396.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.26 |
| Max. Negotiated Rate |
$357.21 |
| Rate for Payer: Aetna Commercial |
$337.36
|
| Rate for Payer: Aetna Medicare |
$103.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.03
|
| Rate for Payer: BCBS Complete |
$158.76
|
| Rate for Payer: BCBS MAPPO |
$99.22
|
| Rate for Payer: BCBS Trust/PPO |
$326.29
|
| Rate for Payer: BCN Commercial |
$308.59
|
| Rate for Payer: BCN Medicare Advantage |
$99.22
|
| Rate for Payer: Cash Price |
$317.52
|
| Rate for Payer: Cofinity Commercial |
$341.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.22
|
| Rate for Payer: Healthscope Commercial |
$357.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.36
|
| Rate for Payer: Nomi Health Commercial |
$325.46
|
| Rate for Payer: PACE Senior Care Partners |
$94.26
|
| Rate for Payer: PACE SWMI |
$99.22
|
| Rate for Payer: PHP Commercial |
$337.36
|
| Rate for Payer: PHP Medicare Advantage |
$99.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.98
|
| Rate for Payer: Priority Health HMO/PPO |
$345.30
|
| Rate for Payer: Priority Health Medicare |
$100.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.92
|
| Rate for Payer: Railroad Medicare Medicare |
$99.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.27
|
| Rate for Payer: UHC Core |
$331.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.22
|
| Rate for Payer: UHC Exchange |
$99.22
|
| Rate for Payer: UHC Medicare Advantage |
$99.22
|
| Rate for Payer: VA VA |
$99.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.68
|
|
|
HC INFUSION CATHETER LVL 3
|
Facility
|
IP
|
$396.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$257.98 |
| Max. Negotiated Rate |
$357.21 |
| Rate for Payer: Aetna Commercial |
$337.36
|
| Rate for Payer: BCBS Trust/PPO |
$323.99
|
| Rate for Payer: BCN Commercial |
$306.72
|
| Rate for Payer: Cash Price |
$317.52
|
| Rate for Payer: Cofinity Commercial |
$341.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.52
|
| Rate for Payer: Healthscope Commercial |
$357.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.36
|
| Rate for Payer: Nomi Health Commercial |
$325.46
|
| Rate for Payer: PHP Commercial |
$337.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.98
|
| Rate for Payer: Priority Health HMO/PPO |
$345.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.27
|
| Rate for Payer: UHC Core |
$331.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.68
|
|
|
HC INFUSION CATHETER LVL 6
|
Facility
|
OP
|
$676.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.58 |
| Max. Negotiated Rate |
$608.51 |
| Rate for Payer: Aetna Commercial |
$574.70
|
| Rate for Payer: Aetna Medicare |
$175.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.29
|
| Rate for Payer: BCBS Complete |
$270.45
|
| Rate for Payer: BCBS MAPPO |
$169.03
|
| Rate for Payer: BCBS Trust/PPO |
$555.84
|
| Rate for Payer: BCN Commercial |
$525.68
|
| Rate for Payer: BCN Medicare Advantage |
$169.03
|
| Rate for Payer: Cash Price |
$540.90
|
| Rate for Payer: Cofinity Commercial |
$581.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.03
|
| Rate for Payer: Healthscope Commercial |
$608.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.70
|
| Rate for Payer: Nomi Health Commercial |
$554.42
|
| Rate for Payer: PACE Senior Care Partners |
$160.58
|
| Rate for Payer: PACE SWMI |
$169.03
|
| Rate for Payer: PHP Commercial |
$574.70
|
| Rate for Payer: PHP Medicare Advantage |
$169.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.48
|
| Rate for Payer: Priority Health HMO/PPO |
$588.22
|
| Rate for Payer: Priority Health Medicare |
$170.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.00
|
| Rate for Payer: Railroad Medicare Medicare |
$169.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.99
|
| Rate for Payer: UHC Core |
$564.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.03
|
| Rate for Payer: UHC Exchange |
$169.03
|
| Rate for Payer: UHC Medicare Advantage |
$169.03
|
| Rate for Payer: VA VA |
$169.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.09
|
|
|
HC INFUSION CATHETER LVL 6
|
Facility
|
IP
|
$676.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$439.48 |
| Max. Negotiated Rate |
$608.51 |
| Rate for Payer: Aetna Commercial |
$574.70
|
| Rate for Payer: BCBS Trust/PPO |
$551.92
|
| Rate for Payer: BCN Commercial |
$522.51
|
| Rate for Payer: Cash Price |
$540.90
|
| Rate for Payer: Cofinity Commercial |
$581.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.90
|
| Rate for Payer: Healthscope Commercial |
$608.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.70
|
| Rate for Payer: Nomi Health Commercial |
$554.42
|
| Rate for Payer: PHP Commercial |
$574.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.48
|
| Rate for Payer: Priority Health HMO/PPO |
$588.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.99
|
| Rate for Payer: UHC Core |
$564.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.09
|
|
|
HC INFUSION CATHETER LVL 7
|
Facility
|
IP
|
$755.19
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$490.87 |
| Max. Negotiated Rate |
$679.67 |
| Rate for Payer: Aetna Commercial |
$641.91
|
| Rate for Payer: BCBS Trust/PPO |
$616.46
|
| Rate for Payer: BCN Commercial |
$583.61
|
| Rate for Payer: Cash Price |
$604.15
|
| Rate for Payer: Cofinity Commercial |
$649.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.15
|
| Rate for Payer: Healthscope Commercial |
$679.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.91
|
| Rate for Payer: Nomi Health Commercial |
$619.26
|
| Rate for Payer: PHP Commercial |
$641.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.87
|
| Rate for Payer: Priority Health HMO/PPO |
$657.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$664.57
|
| Rate for Payer: UHC Core |
$630.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.39
|
|
|
HC INFUSION CATHETER LVL 7
|
Facility
|
OP
|
$755.19
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.36 |
| Max. Negotiated Rate |
$679.67 |
| Rate for Payer: Aetna Commercial |
$641.91
|
| Rate for Payer: Aetna Medicare |
$196.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.00
|
| Rate for Payer: BCBS Complete |
$302.08
|
| Rate for Payer: BCBS MAPPO |
$188.80
|
| Rate for Payer: BCBS Trust/PPO |
$620.84
|
| Rate for Payer: BCN Commercial |
$587.16
|
| Rate for Payer: BCN Medicare Advantage |
$188.80
|
| Rate for Payer: Cash Price |
$604.15
|
| Rate for Payer: Cofinity Commercial |
$649.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.80
|
| Rate for Payer: Healthscope Commercial |
$679.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$641.91
|
| Rate for Payer: Nomi Health Commercial |
$619.26
|
| Rate for Payer: PACE Senior Care Partners |
$179.36
|
| Rate for Payer: PACE SWMI |
$188.80
|
| Rate for Payer: PHP Commercial |
$641.91
|
| Rate for Payer: PHP Medicare Advantage |
$188.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.87
|
| Rate for Payer: Priority Health HMO/PPO |
$657.02
|
| Rate for Payer: Priority Health Medicare |
$190.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.98
|
| Rate for Payer: Railroad Medicare Medicare |
$188.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$664.57
|
| Rate for Payer: UHC Core |
$630.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.80
|
| Rate for Payer: UHC Exchange |
$188.80
|
| Rate for Payer: UHC Medicare Advantage |
$188.80
|
| Rate for Payer: VA VA |
$188.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.39
|
|
|
HC INFUSION CATHETER LVL 9
|
Facility
|
OP
|
$922.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.04 |
| Max. Negotiated Rate |
$830.03 |
| Rate for Payer: Aetna Commercial |
$783.92
|
| Rate for Payer: Aetna Medicare |
$239.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.21
|
| Rate for Payer: BCBS Complete |
$368.90
|
| Rate for Payer: BCBS MAPPO |
$230.56
|
| Rate for Payer: BCBS Trust/PPO |
$758.19
|
| Rate for Payer: BCN Commercial |
$717.06
|
| Rate for Payer: BCN Medicare Advantage |
$230.56
|
| Rate for Payer: Cash Price |
$737.81
|
| Rate for Payer: Cofinity Commercial |
$793.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.56
|
| Rate for Payer: Healthscope Commercial |
$830.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.92
|
| Rate for Payer: Nomi Health Commercial |
$756.25
|
| Rate for Payer: PACE Senior Care Partners |
$219.04
|
| Rate for Payer: PACE SWMI |
$230.56
|
| Rate for Payer: PHP Commercial |
$783.92
|
| Rate for Payer: PHP Medicare Advantage |
$230.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.47
|
| Rate for Payer: Priority Health HMO/PPO |
$802.37
|
| Rate for Payer: Priority Health Medicare |
$232.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.91
|
| Rate for Payer: Railroad Medicare Medicare |
$230.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.59
|
| Rate for Payer: UHC Core |
$770.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.56
|
| Rate for Payer: UHC Exchange |
$230.56
|
| Rate for Payer: UHC Medicare Advantage |
$230.56
|
| Rate for Payer: VA VA |
$230.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.70
|
|
|
HC INFUSION CATHETER LVL 9
|
Facility
|
IP
|
$922.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$599.47 |
| Max. Negotiated Rate |
$830.03 |
| Rate for Payer: Aetna Commercial |
$783.92
|
| Rate for Payer: BCBS Trust/PPO |
$752.84
|
| Rate for Payer: BCN Commercial |
$712.72
|
| Rate for Payer: Cash Price |
$737.81
|
| Rate for Payer: Cofinity Commercial |
$793.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.81
|
| Rate for Payer: Healthscope Commercial |
$830.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.92
|
| Rate for Payer: Nomi Health Commercial |
$756.25
|
| Rate for Payer: PHP Commercial |
$783.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.47
|
| Rate for Payer: Priority Health HMO/PPO |
$802.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.59
|
| Rate for Payer: UHC Core |
$770.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.70
|
|
|
HC INFUSION CATH LVL 10
|
Facility
|
IP
|
$1,026.84
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200310
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$667.45 |
| Max. Negotiated Rate |
$924.16 |
| Rate for Payer: Aetna Commercial |
$872.81
|
| Rate for Payer: BCBS Trust/PPO |
$838.21
|
| Rate for Payer: BCN Commercial |
$793.54
|
| Rate for Payer: Cash Price |
$821.47
|
| Rate for Payer: Cofinity Commercial |
$883.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.47
|
| Rate for Payer: Healthscope Commercial |
$924.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$872.81
|
| Rate for Payer: Nomi Health Commercial |
$842.01
|
| Rate for Payer: PHP Commercial |
$872.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$667.45
|
| Rate for Payer: Priority Health HMO/PPO |
$893.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.62
|
| Rate for Payer: UHC Core |
$857.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.13
|
|
|
HC INFUSION CATH LVL 10
|
Facility
|
OP
|
$1,026.84
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200310
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.87 |
| Max. Negotiated Rate |
$924.16 |
| Rate for Payer: Aetna Commercial |
$872.81
|
| Rate for Payer: Aetna Medicare |
$266.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.89
|
| Rate for Payer: BCBS Complete |
$410.74
|
| Rate for Payer: BCBS MAPPO |
$256.71
|
| Rate for Payer: BCBS Trust/PPO |
$844.17
|
| Rate for Payer: BCN Commercial |
$798.37
|
| Rate for Payer: BCN Medicare Advantage |
$256.71
|
| Rate for Payer: Cash Price |
$821.47
|
| Rate for Payer: Cofinity Commercial |
$883.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.71
|
| Rate for Payer: Healthscope Commercial |
$924.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$269.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$295.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$872.81
|
| Rate for Payer: Nomi Health Commercial |
$842.01
|
| Rate for Payer: PACE Senior Care Partners |
$243.87
|
| Rate for Payer: PACE SWMI |
$256.71
|
| Rate for Payer: PHP Commercial |
$872.81
|
| Rate for Payer: PHP Medicare Advantage |
$256.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$667.45
|
| Rate for Payer: Priority Health HMO/PPO |
$893.35
|
| Rate for Payer: Priority Health Medicare |
$259.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.98
|
| Rate for Payer: Railroad Medicare Medicare |
$256.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$903.62
|
| Rate for Payer: UHC Core |
$857.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.71
|
| Rate for Payer: UHC Exchange |
$256.71
|
| Rate for Payer: UHC Medicare Advantage |
$256.71
|
| Rate for Payer: VA VA |
$256.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.13
|
|
|
HC INFUSION CATH LVL 11
|
Facility
|
OP
|
$1,143.29
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$271.53 |
| Max. Negotiated Rate |
$1,028.96 |
| Rate for Payer: Aetna Commercial |
$971.80
|
| Rate for Payer: Aetna Medicare |
$297.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.28
|
| Rate for Payer: BCBS Complete |
$457.32
|
| Rate for Payer: BCBS MAPPO |
$285.82
|
| Rate for Payer: BCBS Trust/PPO |
$939.90
|
| Rate for Payer: BCN Commercial |
$888.91
|
| Rate for Payer: BCN Medicare Advantage |
$285.82
|
| Rate for Payer: Cash Price |
$914.63
|
| Rate for Payer: Cofinity Commercial |
$983.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.82
|
| Rate for Payer: Healthscope Commercial |
$1,028.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$971.80
|
| Rate for Payer: Nomi Health Commercial |
$937.50
|
| Rate for Payer: PACE Senior Care Partners |
$271.53
|
| Rate for Payer: PACE SWMI |
$285.82
|
| Rate for Payer: PHP Commercial |
$971.80
|
| Rate for Payer: PHP Medicare Advantage |
$285.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.14
|
| Rate for Payer: Priority Health HMO/PPO |
$994.66
|
| Rate for Payer: Priority Health Medicare |
$288.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.00
|
| Rate for Payer: Railroad Medicare Medicare |
$285.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.10
|
| Rate for Payer: UHC Core |
$954.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.82
|
| Rate for Payer: UHC Exchange |
$285.82
|
| Rate for Payer: UHC Medicare Advantage |
$285.82
|
| Rate for Payer: VA VA |
$285.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.47
|
|
|
HC INFUSION CATH LVL 11
|
Facility
|
IP
|
$1,143.29
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$743.14 |
| Max. Negotiated Rate |
$1,028.96 |
| Rate for Payer: Aetna Commercial |
$971.80
|
| Rate for Payer: BCBS Trust/PPO |
$933.27
|
| Rate for Payer: BCN Commercial |
$883.53
|
| Rate for Payer: Cash Price |
$914.63
|
| Rate for Payer: Cofinity Commercial |
$983.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.63
|
| Rate for Payer: Healthscope Commercial |
$1,028.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$971.80
|
| Rate for Payer: Nomi Health Commercial |
$937.50
|
| Rate for Payer: PHP Commercial |
$971.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$743.14
|
| Rate for Payer: Priority Health HMO/PPO |
$994.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,006.10
|
| Rate for Payer: UHC Core |
$954.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.47
|
|
|
HC INFUSION CATH LVL 12
|
Facility
|
OP
|
$1,272.93
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$302.32 |
| Max. Negotiated Rate |
$1,145.64 |
| Rate for Payer: Aetna Commercial |
$1,081.99
|
| Rate for Payer: Aetna Medicare |
$330.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$397.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$397.79
|
| Rate for Payer: BCBS Complete |
$509.17
|
| Rate for Payer: BCBS MAPPO |
$318.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.48
|
| Rate for Payer: BCN Commercial |
$989.70
|
| Rate for Payer: BCN Medicare Advantage |
$318.23
|
| Rate for Payer: Cash Price |
$1,018.34
|
| Rate for Payer: Cofinity Commercial |
$1,094.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.23
|
| Rate for Payer: Healthscope Commercial |
$1,145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$365.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,081.99
|
| Rate for Payer: Nomi Health Commercial |
$1,043.80
|
| Rate for Payer: PACE Senior Care Partners |
$302.32
|
| Rate for Payer: PACE SWMI |
$318.23
|
| Rate for Payer: PHP Commercial |
$1,081.99
|
| Rate for Payer: PHP Medicare Advantage |
$318.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,107.45
|
| Rate for Payer: Priority Health Medicare |
$321.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$852.86
|
| Rate for Payer: Railroad Medicare Medicare |
$318.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.18
|
| Rate for Payer: UHC Core |
$1,062.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.23
|
| Rate for Payer: UHC Exchange |
$318.23
|
| Rate for Payer: UHC Medicare Advantage |
$318.23
|
| Rate for Payer: VA VA |
$318.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.70
|
|
|
HC INFUSION CATH LVL 12
|
Facility
|
IP
|
$1,272.93
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$827.40 |
| Max. Negotiated Rate |
$1,145.64 |
| Rate for Payer: Aetna Commercial |
$1,081.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.09
|
| Rate for Payer: BCN Commercial |
$983.72
|
| Rate for Payer: Cash Price |
$1,018.34
|
| Rate for Payer: Cofinity Commercial |
$1,094.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.34
|
| Rate for Payer: Healthscope Commercial |
$1,145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,081.99
|
| Rate for Payer: Nomi Health Commercial |
$1,043.80
|
| Rate for Payer: PHP Commercial |
$1,081.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,107.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$852.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.18
|
| Rate for Payer: UHC Core |
$1,062.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.70
|
|
|
HC INFUSION CATH LVL 13
|
Facility
|
OP
|
$1,380.06
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$327.76 |
| Max. Negotiated Rate |
$1,242.05 |
| Rate for Payer: Aetna Commercial |
$1,173.05
|
| Rate for Payer: Aetna Medicare |
$358.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.27
|
| Rate for Payer: BCBS Complete |
$552.02
|
| Rate for Payer: BCBS MAPPO |
$345.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,134.55
|
| Rate for Payer: BCN Commercial |
$1,073.00
|
| Rate for Payer: BCN Medicare Advantage |
$345.02
|
| Rate for Payer: Cash Price |
$1,104.05
|
| Rate for Payer: Cofinity Commercial |
$1,186.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.02
|
| Rate for Payer: Healthscope Commercial |
$1,242.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$396.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.05
|
| Rate for Payer: Nomi Health Commercial |
$1,131.65
|
| Rate for Payer: PACE Senior Care Partners |
$327.76
|
| Rate for Payer: PACE SWMI |
$345.02
|
| Rate for Payer: PHP Commercial |
$1,173.05
|
| Rate for Payer: PHP Medicare Advantage |
$345.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,200.65
|
| Rate for Payer: Priority Health Medicare |
$348.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.64
|
| Rate for Payer: Railroad Medicare Medicare |
$345.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.45
|
| Rate for Payer: UHC Core |
$1,152.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.02
|
| Rate for Payer: UHC Exchange |
$345.02
|
| Rate for Payer: UHC Medicare Advantage |
$345.02
|
| Rate for Payer: VA VA |
$345.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.04
|
|
|
HC INFUSION CATH LVL 13
|
Facility
|
IP
|
$1,380.06
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$897.04 |
| Max. Negotiated Rate |
$1,242.05 |
| Rate for Payer: Aetna Commercial |
$1,173.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,126.54
|
| Rate for Payer: BCN Commercial |
$1,066.51
|
| Rate for Payer: Cash Price |
$1,104.05
|
| Rate for Payer: Cofinity Commercial |
$1,186.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.05
|
| Rate for Payer: Healthscope Commercial |
$1,242.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,173.05
|
| Rate for Payer: Nomi Health Commercial |
$1,131.65
|
| Rate for Payer: PHP Commercial |
$1,173.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,200.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$924.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,214.45
|
| Rate for Payer: UHC Core |
$1,152.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.04
|
|
|
HC INFUSION CATH LVL 14
|
Facility
|
OP
|
$1,475.84
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200267
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$350.51 |
| Max. Negotiated Rate |
$1,328.26 |
| Rate for Payer: Aetna Commercial |
$1,254.46
|
| Rate for Payer: Aetna Medicare |
$383.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$461.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$461.20
|
| Rate for Payer: BCBS Complete |
$590.34
|
| Rate for Payer: BCBS MAPPO |
$368.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,213.29
|
| Rate for Payer: BCN Commercial |
$1,147.47
|
| Rate for Payer: BCN Medicare Advantage |
$368.96
|
| Rate for Payer: Cash Price |
$1,180.67
|
| Rate for Payer: Cofinity Commercial |
$1,269.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$368.96
|
| Rate for Payer: Healthscope Commercial |
$1,328.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,254.46
|
| Rate for Payer: Nomi Health Commercial |
$1,210.19
|
| Rate for Payer: PACE Senior Care Partners |
$350.51
|
| Rate for Payer: PACE SWMI |
$368.96
|
| Rate for Payer: PHP Commercial |
$1,254.46
|
| Rate for Payer: PHP Medicare Advantage |
$368.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$959.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,283.98
|
| Rate for Payer: Priority Health Medicare |
$372.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.81
|
| Rate for Payer: Railroad Medicare Medicare |
$368.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.74
|
| Rate for Payer: UHC Core |
$1,232.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$368.96
|
| Rate for Payer: UHC Exchange |
$368.96
|
| Rate for Payer: UHC Medicare Advantage |
$368.96
|
| Rate for Payer: VA VA |
$368.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.88
|
|
|
HC INFUSION CATH LVL 14
|
Facility
|
IP
|
$1,475.84
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200267
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$959.30 |
| Max. Negotiated Rate |
$1,328.26 |
| Rate for Payer: Aetna Commercial |
$1,254.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.73
|
| Rate for Payer: BCN Commercial |
$1,140.53
|
| Rate for Payer: Cash Price |
$1,180.67
|
| Rate for Payer: Cofinity Commercial |
$1,269.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,180.67
|
| Rate for Payer: Healthscope Commercial |
$1,328.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,106.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,254.46
|
| Rate for Payer: Nomi Health Commercial |
$1,210.19
|
| Rate for Payer: PHP Commercial |
$1,254.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$959.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,283.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$988.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,298.74
|
| Rate for Payer: UHC Core |
$1,232.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,106.88
|
|
|
HC INFUSION CATH LVL 4
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200093
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$298.35 |
| Max. Negotiated Rate |
$413.10 |
| Rate for Payer: Aetna Commercial |
$390.15
|
| Rate for Payer: BCBS Trust/PPO |
$374.68
|
| Rate for Payer: BCN Commercial |
$354.72
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$394.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.20
|
| Rate for Payer: Healthscope Commercial |
$413.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.15
|
| Rate for Payer: Nomi Health Commercial |
$376.38
|
| Rate for Payer: PHP Commercial |
$390.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.35
|
| Rate for Payer: Priority Health HMO/PPO |
$399.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.92
|
| Rate for Payer: UHC Core |
$383.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.25
|
|
