|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,340.24
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$871.16 |
| Max. Negotiated Rate |
$1,206.22 |
| Rate for Payer: Aetna Commercial |
$1,139.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.04
|
| Rate for Payer: BCN Commercial |
$1,035.74
|
| Rate for Payer: Cash Price |
$1,072.19
|
| Rate for Payer: Cofinity Commercial |
$1,152.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.19
|
| Rate for Payer: Healthscope Commercial |
$1,206.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.20
|
| Rate for Payer: Nomi Health Commercial |
$1,099.00
|
| Rate for Payer: PHP Commercial |
$1,139.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$871.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,166.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,179.41
|
| Rate for Payer: UHC Core |
$1,119.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.18
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,073.12
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$158.77 |
| Max. Negotiated Rate |
$965.81 |
| Rate for Payer: Aetna Commercial |
$912.15
|
| Rate for Payer: Aetna Medicare |
$279.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.35
|
| Rate for Payer: BCBS Complete |
$166.72
|
| Rate for Payer: BCBS MAPPO |
$268.28
|
| Rate for Payer: BCBS Trust/PPO |
$882.21
|
| Rate for Payer: BCN Commercial |
$834.35
|
| Rate for Payer: BCN Medicare Advantage |
$268.28
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cofinity Commercial |
$922.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.28
|
| Rate for Payer: Healthscope Commercial |
$965.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.84
|
| Rate for Payer: Mclaren Medicaid |
$158.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.69
|
| Rate for Payer: Meridian Medicaid |
$166.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.15
|
| Rate for Payer: Nomi Health Commercial |
$879.96
|
| Rate for Payer: PACE Senior Care Partners |
$254.87
|
| Rate for Payer: PACE SWMI |
$268.28
|
| Rate for Payer: PHP Commercial |
$912.15
|
| Rate for Payer: PHP Medicare Advantage |
$268.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.53
|
| Rate for Payer: Priority Health HMO/PPO |
$933.61
|
| Rate for Payer: Priority Health Medicare |
$270.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.99
|
| Rate for Payer: Railroad Medicare Medicare |
$268.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.35
|
| Rate for Payer: UHC Core |
$896.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.28
|
| Rate for Payer: UHC Exchange |
$268.28
|
| Rate for Payer: UHC Medicare Advantage |
$268.28
|
| Rate for Payer: UHCCP Medicaid |
$158.77
|
| Rate for Payer: VA VA |
$268.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.84
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,073.12
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$697.53 |
| Max. Negotiated Rate |
$965.81 |
| Rate for Payer: Aetna Commercial |
$912.15
|
| Rate for Payer: BCBS Trust/PPO |
$875.99
|
| Rate for Payer: BCN Commercial |
$829.31
|
| Rate for Payer: Cash Price |
$858.50
|
| Rate for Payer: Cofinity Commercial |
$922.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.50
|
| Rate for Payer: Healthscope Commercial |
$965.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.15
|
| Rate for Payer: Nomi Health Commercial |
$879.96
|
| Rate for Payer: PHP Commercial |
$912.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.53
|
| Rate for Payer: Priority Health HMO/PPO |
$933.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.35
|
| Rate for Payer: UHC Core |
$896.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.84
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,148.49
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,046.52 |
| Max. Negotiated Rate |
$2,833.64 |
| Rate for Payer: Aetna Commercial |
$2,676.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,570.11
|
| Rate for Payer: BCN Commercial |
$2,433.15
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cofinity Commercial |
$2,707.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,518.79
|
| Rate for Payer: Healthscope Commercial |
$2,833.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,361.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,676.22
|
| Rate for Payer: Nomi Health Commercial |
$2,581.76
|
| Rate for Payer: PHP Commercial |
$2,676.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,739.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,109.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,770.67
|
| Rate for Payer: UHC Core |
$2,628.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,361.37
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,148.49
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$747.77 |
| Max. Negotiated Rate |
$5,644.40 |
| Rate for Payer: Aetna Commercial |
$2,676.22
|
| Rate for Payer: Aetna Medicare |
$818.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$983.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$983.90
|
| Rate for Payer: BCBS Complete |
$5,644.40
|
| Rate for Payer: BCBS MAPPO |
$787.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,588.37
|
| Rate for Payer: BCN Commercial |
$2,447.95
|
| Rate for Payer: BCN Medicare Advantage |
$787.12
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cash Price |
$2,518.79
|
| Rate for Payer: Cofinity Commercial |
$2,707.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,518.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.12
|
| Rate for Payer: Healthscope Commercial |
$2,833.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,361.37
|
| Rate for Payer: Mclaren Medicaid |
$5,375.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.48
|
| Rate for Payer: Meridian Medicaid |
$5,644.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$905.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,676.22
|
| Rate for Payer: Nomi Health Commercial |
$2,581.76
|
| Rate for Payer: PACE Senior Care Partners |
$747.77
|
| Rate for Payer: PACE SWMI |
$787.12
|
| Rate for Payer: PHP Commercial |
$2,676.22
|
| Rate for Payer: PHP Medicare Advantage |
$787.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,375.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.52
|
| Rate for Payer: Priority Health HMO/PPO |
$2,739.19
|
| Rate for Payer: Priority Health Medicare |
$794.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,109.49
|
| Rate for Payer: Railroad Medicare Medicare |
$787.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,770.67
|
| Rate for Payer: UHC Core |
$2,628.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.12
|
| Rate for Payer: UHC Exchange |
$787.12
|
| Rate for Payer: UHC Medicare Advantage |
$787.12
|
| Rate for Payer: UHCCP Medicaid |
$5,375.27
|
| Rate for Payer: VA VA |
$787.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,361.37
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$3,037.97
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$721.52 |
| Max. Negotiated Rate |
$5,644.40 |
| Rate for Payer: Aetna Commercial |
$2,582.27
|
| Rate for Payer: Aetna Medicare |
$789.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$949.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$949.37
|
| Rate for Payer: BCBS Complete |
$5,644.40
|
| Rate for Payer: BCBS MAPPO |
$759.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,497.52
|
| Rate for Payer: BCN Commercial |
$2,362.02
|
| Rate for Payer: BCN Medicare Advantage |
$759.49
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cofinity Commercial |
$2,612.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.49
|
| Rate for Payer: Healthscope Commercial |
$2,734.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,278.48
|
| Rate for Payer: Mclaren Medicaid |
$5,375.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$797.47
|
| Rate for Payer: Meridian Medicaid |
$5,644.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.27
|
| Rate for Payer: Nomi Health Commercial |
$2,491.14
|
| Rate for Payer: PACE Senior Care Partners |
$721.52
|
| Rate for Payer: PACE SWMI |
$759.49
|
| Rate for Payer: PHP Commercial |
$2,582.27
|
| Rate for Payer: PHP Medicare Advantage |
$759.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,375.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,643.03
|
| Rate for Payer: Priority Health Medicare |
$767.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.44
|
| Rate for Payer: Railroad Medicare Medicare |
$759.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,673.41
|
| Rate for Payer: UHC Core |
$2,536.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.49
|
| Rate for Payer: UHC Exchange |
$759.49
|
| Rate for Payer: UHC Medicare Advantage |
$759.49
|
| Rate for Payer: UHCCP Medicaid |
$5,375.27
|
| Rate for Payer: VA VA |
$759.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,278.48
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$3,037.97
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,974.68 |
| Max. Negotiated Rate |
$2,734.17 |
| Rate for Payer: Aetna Commercial |
$2,582.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,479.89
|
| Rate for Payer: BCN Commercial |
$2,347.74
|
| Rate for Payer: Cash Price |
$2,430.38
|
| Rate for Payer: Cofinity Commercial |
$2,612.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.38
|
| Rate for Payer: Healthscope Commercial |
$2,734.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,278.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,582.27
|
| Rate for Payer: Nomi Health Commercial |
$2,491.14
|
| Rate for Payer: PHP Commercial |
$2,582.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,974.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,643.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,673.41
|
| Rate for Payer: UHC Core |
$2,536.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,278.48
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,511.38
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,308.95 |
| Max. Negotiated Rate |
$4,960.24 |
| Rate for Payer: Aetna Commercial |
$4,684.67
|
| Rate for Payer: Aetna Medicare |
$1,432.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,722.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,722.31
|
| Rate for Payer: BCBS Complete |
$2,204.55
|
| Rate for Payer: BCBS MAPPO |
$1,377.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,530.91
|
| Rate for Payer: BCN Commercial |
$4,285.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,377.84
|
| Rate for Payer: Cash Price |
$4,409.10
|
| Rate for Payer: Cofinity Commercial |
$4,739.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,409.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,377.84
|
| Rate for Payer: Healthscope Commercial |
$4,960.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,133.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,446.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,584.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,684.67
|
| Rate for Payer: Nomi Health Commercial |
$4,519.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,308.95
|
| Rate for Payer: PACE SWMI |
$1,377.84
|
| Rate for Payer: PHP Commercial |
$4,684.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,377.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.40
|
| Rate for Payer: Priority Health HMO/PPO |
$4,794.90
|
| Rate for Payer: Priority Health Medicare |
$1,391.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,692.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,377.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,850.01
|
| Rate for Payer: UHC Core |
$4,602.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,377.84
|
| Rate for Payer: UHC Exchange |
$1,377.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,377.84
|
| Rate for Payer: VA VA |
$1,377.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,133.54
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,511.38
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,582.40 |
| Max. Negotiated Rate |
$4,960.24 |
| Rate for Payer: Aetna Commercial |
$4,684.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,498.94
|
| Rate for Payer: BCN Commercial |
$4,259.19
|
| Rate for Payer: Cash Price |
$4,409.10
|
| Rate for Payer: Cofinity Commercial |
$4,739.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,409.10
|
| Rate for Payer: Healthscope Commercial |
$4,960.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,133.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,684.67
|
| Rate for Payer: Nomi Health Commercial |
$4,519.33
|
| Rate for Payer: PHP Commercial |
$4,684.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,582.40
|
| Rate for Payer: Priority Health HMO/PPO |
$4,794.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,692.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,850.01
|
| Rate for Payer: UHC Core |
$4,602.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,133.54
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,575.00 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,489.65
|
| Rate for Payer: BCN Commercial |
$4,250.40
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,575.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,785.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,685.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,840.00
|
| Rate for Payer: UHC Core |
$4,592.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,306.25 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: Aetna Medicare |
$1,430.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,718.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,718.75
|
| Rate for Payer: BCBS Complete |
$2,200.00
|
| Rate for Payer: BCBS MAPPO |
$1,375.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,521.55
|
| Rate for Payer: BCN Commercial |
$4,276.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,375.00
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,375.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,443.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,581.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Nomi Health Commercial |
$4,510.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,306.25
|
| Rate for Payer: PACE SWMI |
$1,375.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,375.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,575.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,785.00
|
| Rate for Payer: Priority Health Medicare |
$1,388.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,685.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,840.00
|
| Rate for Payer: UHC Core |
$4,592.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,375.00
|
| Rate for Payer: UHC Exchange |
$1,375.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,375.00
|
| Rate for Payer: VA VA |
$1,375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$573.26
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$372.62 |
| Max. Negotiated Rate |
$515.93 |
| Rate for Payer: Aetna Commercial |
$487.27
|
| Rate for Payer: BCBS Trust/PPO |
$467.95
|
| Rate for Payer: BCN Commercial |
$443.02
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cofinity Commercial |
$493.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.61
|
| Rate for Payer: Healthscope Commercial |
$515.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.27
|
| Rate for Payer: Nomi Health Commercial |
$470.07
|
| Rate for Payer: PHP Commercial |
$487.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.62
|
| Rate for Payer: Priority Health HMO/PPO |
$498.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.47
|
| Rate for Payer: UHC Core |
$478.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.94
|
|
|
HC INTRACAV APPL - I
|
Facility
|
OP
|
$573.26
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$136.15 |
| Max. Negotiated Rate |
$515.93 |
| Rate for Payer: Aetna Commercial |
$487.27
|
| Rate for Payer: Aetna Medicare |
$149.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.14
|
| Rate for Payer: BCBS Complete |
$430.29
|
| Rate for Payer: BCBS MAPPO |
$143.32
|
| Rate for Payer: BCBS Trust/PPO |
$471.28
|
| Rate for Payer: BCN Commercial |
$445.71
|
| Rate for Payer: BCN Medicare Advantage |
$143.32
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cash Price |
$458.61
|
| Rate for Payer: Cofinity Commercial |
$493.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.32
|
| Rate for Payer: Healthscope Commercial |
$515.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.94
|
| Rate for Payer: Mclaren Medicaid |
$409.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.48
|
| Rate for Payer: Meridian Medicaid |
$430.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.27
|
| Rate for Payer: Nomi Health Commercial |
$470.07
|
| Rate for Payer: PACE Senior Care Partners |
$136.15
|
| Rate for Payer: PACE SWMI |
$143.32
|
| Rate for Payer: PHP Commercial |
$487.27
|
| Rate for Payer: PHP Medicare Advantage |
$143.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.62
|
| Rate for Payer: Priority Health HMO/PPO |
$498.74
|
| Rate for Payer: Priority Health Medicare |
$144.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.08
|
| Rate for Payer: Railroad Medicare Medicare |
$143.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.47
|
| Rate for Payer: UHC Core |
$478.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.32
|
| Rate for Payer: UHC Exchange |
$143.32
|
| Rate for Payer: UHC Medicare Advantage |
$143.32
|
| Rate for Payer: UHCCP Medicaid |
$409.77
|
| Rate for Payer: VA VA |
$143.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.94
|
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$436.97
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$103.78 |
| Max. Negotiated Rate |
$430.29 |
| Rate for Payer: Aetna Commercial |
$371.42
|
| Rate for Payer: Aetna Medicare |
$113.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.55
|
| Rate for Payer: BCBS Complete |
$430.29
|
| Rate for Payer: BCBS MAPPO |
$109.24
|
| Rate for Payer: BCBS Trust/PPO |
$359.23
|
| Rate for Payer: BCN Commercial |
$339.74
|
| Rate for Payer: BCN Medicare Advantage |
$109.24
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$375.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.24
|
| Rate for Payer: Healthscope Commercial |
$393.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.73
|
| Rate for Payer: Mclaren Medicaid |
$409.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.70
|
| Rate for Payer: Meridian Medicaid |
$430.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PACE Senior Care Partners |
$103.78
|
| Rate for Payer: PACE SWMI |
$109.24
|
| Rate for Payer: PHP Commercial |
$371.42
|
| Rate for Payer: PHP Medicare Advantage |
$109.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO |
$380.16
|
| Rate for Payer: Priority Health Medicare |
$110.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.77
|
| Rate for Payer: Railroad Medicare Medicare |
$109.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.53
|
| Rate for Payer: UHC Core |
$364.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.24
|
| Rate for Payer: UHC Exchange |
$109.24
|
| Rate for Payer: UHC Medicare Advantage |
$109.24
|
| Rate for Payer: UHCCP Medicaid |
$409.77
|
| Rate for Payer: VA VA |
$109.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.73
|
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$436.97
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$284.03 |
| Max. Negotiated Rate |
$393.27 |
| Rate for Payer: Aetna Commercial |
$371.42
|
| Rate for Payer: BCBS Trust/PPO |
$356.70
|
| Rate for Payer: BCN Commercial |
$337.69
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$375.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Healthscope Commercial |
$393.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PHP Commercial |
$371.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO |
$380.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.53
|
| Rate for Payer: UHC Core |
$364.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.73
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$484.89
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.16 |
| Max. Negotiated Rate |
$436.40 |
| Rate for Payer: Aetna Commercial |
$412.16
|
| Rate for Payer: Aetna Medicare |
$126.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.53
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$121.22
|
| Rate for Payer: BCBS Trust/PPO |
$398.63
|
| Rate for Payer: BCN Commercial |
$377.00
|
| Rate for Payer: BCN Medicare Advantage |
$121.22
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cofinity Commercial |
$417.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.22
|
| Rate for Payer: Healthscope Commercial |
$436.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.67
|
| Rate for Payer: Mclaren Medicaid |
$282.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.28
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.16
|
| Rate for Payer: Nomi Health Commercial |
$397.61
|
| Rate for Payer: PACE Senior Care Partners |
$115.16
|
| Rate for Payer: PACE SWMI |
$121.22
|
| Rate for Payer: PHP Commercial |
$412.16
|
| Rate for Payer: PHP Medicare Advantage |
$121.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.18
|
| Rate for Payer: Priority Health HMO/PPO |
$421.85
|
| Rate for Payer: Priority Health Medicare |
$122.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: Railroad Medicare Medicare |
$121.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.70
|
| Rate for Payer: UHC Core |
$404.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.22
|
| Rate for Payer: UHC Exchange |
$121.22
|
| Rate for Payer: UHC Medicare Advantage |
$121.22
|
| Rate for Payer: UHCCP Medicaid |
$282.67
|
| Rate for Payer: VA VA |
$121.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.67
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$484.89
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$315.18 |
| Max. Negotiated Rate |
$436.40 |
| Rate for Payer: Aetna Commercial |
$412.16
|
| Rate for Payer: BCBS Trust/PPO |
$395.82
|
| Rate for Payer: BCN Commercial |
$374.72
|
| Rate for Payer: Cash Price |
$387.91
|
| Rate for Payer: Cofinity Commercial |
$417.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.91
|
| Rate for Payer: Healthscope Commercial |
$436.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.16
|
| Rate for Payer: Nomi Health Commercial |
$397.61
|
| Rate for Payer: PHP Commercial |
$412.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.18
|
| Rate for Payer: Priority Health HMO/PPO |
$421.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.70
|
| Rate for Payer: UHC Core |
$404.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.67
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
OP
|
$292.74
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.53 |
| Max. Negotiated Rate |
$263.47 |
| Rate for Payer: Aetna Commercial |
$248.83
|
| Rate for Payer: Aetna Medicare |
$76.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.48
|
| Rate for Payer: BCBS Complete |
$117.10
|
| Rate for Payer: BCBS MAPPO |
$73.18
|
| Rate for Payer: BCBS Trust/PPO |
$240.66
|
| Rate for Payer: BCN Commercial |
$227.61
|
| Rate for Payer: BCN Medicare Advantage |
$73.18
|
| Rate for Payer: Cash Price |
$234.19
|
| Rate for Payer: Cofinity Commercial |
$251.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.18
|
| Rate for Payer: Healthscope Commercial |
$263.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.83
|
| Rate for Payer: Nomi Health Commercial |
$240.05
|
| Rate for Payer: PACE Senior Care Partners |
$69.53
|
| Rate for Payer: PACE SWMI |
$73.18
|
| Rate for Payer: PHP Commercial |
$248.83
|
| Rate for Payer: PHP Medicare Advantage |
$73.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.28
|
| Rate for Payer: Priority Health HMO/PPO |
$254.68
|
| Rate for Payer: Priority Health Medicare |
$73.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.14
|
| Rate for Payer: Railroad Medicare Medicare |
$73.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.61
|
| Rate for Payer: UHC Core |
$244.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.18
|
| Rate for Payer: UHC Exchange |
$73.18
|
| Rate for Payer: UHC Medicare Advantage |
$73.18
|
| Rate for Payer: VA VA |
$73.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.56
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$292.74
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$190.28 |
| Max. Negotiated Rate |
$263.47 |
| Rate for Payer: Aetna Commercial |
$248.83
|
| Rate for Payer: BCBS Trust/PPO |
$238.96
|
| Rate for Payer: BCN Commercial |
$226.23
|
| Rate for Payer: Cash Price |
$234.19
|
| Rate for Payer: Cofinity Commercial |
$251.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.19
|
| Rate for Payer: Healthscope Commercial |
$263.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.83
|
| Rate for Payer: Nomi Health Commercial |
$240.05
|
| Rate for Payer: PHP Commercial |
$248.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.28
|
| Rate for Payer: Priority Health HMO/PPO |
$254.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.61
|
| Rate for Payer: UHC Core |
$244.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.56
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,765.44
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$419.29 |
| Max. Negotiated Rate |
$1,588.90 |
| Rate for Payer: Aetna Commercial |
$1,500.62
|
| Rate for Payer: Aetna Medicare |
$459.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.70
|
| Rate for Payer: BCBS Complete |
$706.18
|
| Rate for Payer: BCBS MAPPO |
$441.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.37
|
| Rate for Payer: BCN Commercial |
$1,372.63
|
| Rate for Payer: BCN Medicare Advantage |
$441.36
|
| Rate for Payer: Cash Price |
$1,412.35
|
| Rate for Payer: Cofinity Commercial |
$1,518.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.36
|
| Rate for Payer: Healthscope Commercial |
$1,588.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,324.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$463.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$507.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,500.62
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Senior Care Partners |
$419.29
|
| Rate for Payer: PACE SWMI |
$441.36
|
| Rate for Payer: PHP Commercial |
$1,500.62
|
| Rate for Payer: PHP Medicare Advantage |
$441.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,535.93
|
| Rate for Payer: Priority Health Medicare |
$445.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.84
|
| Rate for Payer: Railroad Medicare Medicare |
$441.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,553.59
|
| Rate for Payer: UHC Core |
$1,474.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.36
|
| Rate for Payer: UHC Exchange |
$441.36
|
| Rate for Payer: UHC Medicare Advantage |
$441.36
|
| Rate for Payer: VA VA |
$441.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,324.08
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,765.44
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,147.54 |
| Max. Negotiated Rate |
$1,588.90 |
| Rate for Payer: Aetna Commercial |
$1,500.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.13
|
| Rate for Payer: BCN Commercial |
$1,364.33
|
| Rate for Payer: Cash Price |
$1,412.35
|
| Rate for Payer: Cofinity Commercial |
$1,518.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,412.35
|
| Rate for Payer: Healthscope Commercial |
$1,588.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,324.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,500.62
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PHP Commercial |
$1,500.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,147.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,535.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,553.59
|
| Rate for Payer: UHC Core |
$1,474.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,324.08
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,767.24
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$894.72 |
| Max. Negotiated Rate |
$5,644.40 |
| Rate for Payer: Aetna Commercial |
$3,202.15
|
| Rate for Payer: Aetna Medicare |
$979.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,177.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,177.26
|
| Rate for Payer: BCBS Complete |
$5,644.40
|
| Rate for Payer: BCBS MAPPO |
$941.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.05
|
| Rate for Payer: BCN Commercial |
$2,929.03
|
| Rate for Payer: BCN Medicare Advantage |
$941.81
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$3,239.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.81
|
| Rate for Payer: Healthscope Commercial |
$3,390.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.43
|
| Rate for Payer: Mclaren Medicaid |
$5,375.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$988.90
|
| Rate for Payer: Meridian Medicaid |
$5,644.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,083.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: Nomi Health Commercial |
$3,089.14
|
| Rate for Payer: PACE Senior Care Partners |
$894.72
|
| Rate for Payer: PACE SWMI |
$941.81
|
| Rate for Payer: PHP Commercial |
$3,202.15
|
| Rate for Payer: PHP Medicare Advantage |
$941.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,375.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: Priority Health HMO/PPO |
$3,277.50
|
| Rate for Payer: Priority Health Medicare |
$951.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,524.05
|
| Rate for Payer: Railroad Medicare Medicare |
$941.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.17
|
| Rate for Payer: UHC Core |
$3,145.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$941.81
|
| Rate for Payer: UHC Exchange |
$941.81
|
| Rate for Payer: UHC Medicare Advantage |
$941.81
|
| Rate for Payer: UHCCP Medicaid |
$5,375.27
|
| Rate for Payer: VA VA |
$941.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.43
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,767.24
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,448.71 |
| Max. Negotiated Rate |
$3,390.52 |
| Rate for Payer: Aetna Commercial |
$3,202.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,075.20
|
| Rate for Payer: BCN Commercial |
$2,911.32
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$3,239.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Healthscope Commercial |
$3,390.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: Nomi Health Commercial |
$3,089.14
|
| Rate for Payer: PHP Commercial |
$3,202.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: Priority Health HMO/PPO |
$3,277.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,524.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.17
|
| Rate for Payer: UHC Core |
$3,145.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.43
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$39.97
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$11.45
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$40.25
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$10.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: Meridian Medicaid |
$11.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Exchange |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.24
|
| Rate for Payer: UHCCP Medicaid |
$10.90
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
