|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,745.44
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$889.54 |
| Max. Negotiated Rate |
$3,370.90 |
| Rate for Payer: Aetna Commercial |
$3,183.62
|
| Rate for Payer: Aetna Medicare |
$973.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,170.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,170.45
|
| Rate for Payer: BCBS Complete |
$1,498.18
|
| Rate for Payer: BCBS MAPPO |
$936.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.13
|
| Rate for Payer: BCN Commercial |
$2,912.08
|
| Rate for Payer: BCN Medicare Advantage |
$936.36
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.36
|
| Rate for Payer: Healthscope Commercial |
$3,370.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,809.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,076.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: PACE Senior Care Partners |
$889.54
|
| Rate for Payer: PACE SWMI |
$936.36
|
| Rate for Payer: PHP Commercial |
$3,183.62
|
| Rate for Payer: PHP Medicare Advantage |
$936.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,434.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3,258.53
|
| Rate for Payer: Priority Health Medicare |
$945.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,509.44
|
| Rate for Payer: Railroad Medicare Medicare |
$936.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,295.99
|
| Rate for Payer: UHC Core |
$3,127.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$936.36
|
| Rate for Payer: UHC Exchange |
$936.36
|
| Rate for Payer: UHC Medicare Advantage |
$936.36
|
| Rate for Payer: VA VA |
$936.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,809.08
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,745.44
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,434.54 |
| Max. Negotiated Rate |
$3,370.90 |
| Rate for Payer: Aetna Commercial |
$3,183.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,057.40
|
| Rate for Payer: BCN Commercial |
$2,894.48
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,370.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,809.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: PHP Commercial |
$3,183.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,434.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3,258.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,509.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,295.99
|
| Rate for Payer: UHC Core |
$3,127.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,809.08
|
|
|
HC INTRODUCER
|
Facility
|
IP
|
$299.58
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.73 |
| Max. Negotiated Rate |
$269.62 |
| Rate for Payer: Aetna Commercial |
$254.64
|
| Rate for Payer: BCBS Trust/PPO |
$244.55
|
| Rate for Payer: BCN Commercial |
$231.52
|
| Rate for Payer: Cash Price |
$239.66
|
| Rate for Payer: Cofinity Commercial |
$257.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.66
|
| Rate for Payer: Healthscope Commercial |
$269.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.64
|
| Rate for Payer: Nomi Health Commercial |
$245.66
|
| Rate for Payer: PHP Commercial |
$254.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.73
|
| Rate for Payer: Priority Health HMO/PPO |
$260.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.63
|
| Rate for Payer: UHC Core |
$250.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.68
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$299.58
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.15 |
| Max. Negotiated Rate |
$269.62 |
| Rate for Payer: Aetna Commercial |
$254.64
|
| Rate for Payer: Aetna Medicare |
$77.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.62
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$74.90
|
| Rate for Payer: BCBS Trust/PPO |
$246.28
|
| Rate for Payer: BCN Commercial |
$232.92
|
| Rate for Payer: BCN Medicare Advantage |
$74.90
|
| Rate for Payer: Cash Price |
$239.66
|
| Rate for Payer: Cofinity Commercial |
$257.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.90
|
| Rate for Payer: Healthscope Commercial |
$269.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.64
|
| Rate for Payer: Nomi Health Commercial |
$245.66
|
| Rate for Payer: PACE Senior Care Partners |
$71.15
|
| Rate for Payer: PACE SWMI |
$74.90
|
| Rate for Payer: PHP Commercial |
$254.64
|
| Rate for Payer: PHP Medicare Advantage |
$74.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.73
|
| Rate for Payer: Priority Health HMO/PPO |
$260.63
|
| Rate for Payer: Priority Health Medicare |
$75.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.72
|
| Rate for Payer: Railroad Medicare Medicare |
$74.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.63
|
| Rate for Payer: UHC Core |
$250.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.90
|
| Rate for Payer: UHC Exchange |
$74.90
|
| Rate for Payer: UHC Medicare Advantage |
$74.90
|
| Rate for Payer: VA VA |
$74.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.68
|
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.70 |
| Max. Negotiated Rate |
$229.44 |
| Rate for Payer: Aetna Commercial |
$216.69
|
| Rate for Payer: BCBS Trust/PPO |
$208.10
|
| Rate for Payer: BCN Commercial |
$197.01
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Healthscope Commercial |
$229.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: PHP Commercial |
$216.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: Priority Health HMO/PPO |
$221.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.34
|
| Rate for Payer: UHC Core |
$212.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.20
|
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.55 |
| Max. Negotiated Rate |
$229.44 |
| Rate for Payer: Aetna Commercial |
$216.69
|
| Rate for Payer: Aetna Medicare |
$66.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.67
|
| Rate for Payer: BCBS Complete |
$101.97
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.58
|
| Rate for Payer: BCN Commercial |
$198.21
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: PACE Senior Care Partners |
$60.55
|
| Rate for Payer: PACE SWMI |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.69
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: Priority Health HMO/PPO |
$221.79
|
| Rate for Payer: Priority Health Medicare |
$64.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.80
|
| Rate for Payer: Railroad Medicare Medicare |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.34
|
| Rate for Payer: UHC Core |
$212.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.73
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: VA VA |
$63.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.20
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
OP
|
$94.68
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$85.21 |
| Rate for Payer: Aetna Commercial |
$80.48
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.59
|
| Rate for Payer: BCBS Complete |
$37.87
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$77.84
|
| Rate for Payer: BCN Commercial |
$73.61
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$81.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Healthscope Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: PACE Senior Care Partners |
$22.49
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Commercial |
$80.48
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: Priority Health HMO/PPO |
$82.37
|
| Rate for Payer: Priority Health Medicare |
$23.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.44
|
| Rate for Payer: Railroad Medicare Medicare |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.32
|
| Rate for Payer: UHC Core |
$79.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Exchange |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: VA VA |
$23.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.01
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
IP
|
$94.68
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$85.21 |
| Rate for Payer: Aetna Commercial |
$80.48
|
| Rate for Payer: BCBS Trust/PPO |
$77.29
|
| Rate for Payer: BCN Commercial |
$73.17
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$81.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: PHP Commercial |
$80.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: Priority Health HMO/PPO |
$82.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.32
|
| Rate for Payer: UHC Core |
$79.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.01
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
IP
|
$3,457.60
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,247.44 |
| Max. Negotiated Rate |
$3,111.84 |
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,822.44
|
| Rate for Payer: BCN Commercial |
$2,672.03
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health HMO/PPO |
$3,008.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,316.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,042.69
|
| Rate for Payer: UHC Core |
$2,887.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.20
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$821.18 |
| Max. Negotiated Rate |
$3,781.45 |
| Rate for Payer: Aetna Commercial |
$2,938.96
|
| Rate for Payer: Aetna Medicare |
$898.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,080.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,080.50
|
| Rate for Payer: BCBS Complete |
$3,781.45
|
| Rate for Payer: BCBS MAPPO |
$864.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,842.49
|
| Rate for Payer: BCN Commercial |
$2,688.28
|
| Rate for Payer: BCN Medicare Advantage |
$864.40
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cash Price |
$2,766.08
|
| Rate for Payer: Cofinity Commercial |
$2,973.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.40
|
| Rate for Payer: Healthscope Commercial |
$3,111.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.20
|
| Rate for Payer: Mclaren Medicaid |
$3,601.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.62
|
| Rate for Payer: Meridian Medicaid |
$3,781.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$994.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,938.96
|
| Rate for Payer: Nomi Health Commercial |
$2,835.23
|
| Rate for Payer: PACE Senior Care Partners |
$821.18
|
| Rate for Payer: PACE SWMI |
$864.40
|
| Rate for Payer: PHP Commercial |
$2,938.96
|
| Rate for Payer: PHP Medicare Advantage |
$864.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,601.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,247.44
|
| Rate for Payer: Priority Health HMO/PPO |
$3,008.11
|
| Rate for Payer: Priority Health Medicare |
$873.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,316.59
|
| Rate for Payer: Railroad Medicare Medicare |
$864.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,042.69
|
| Rate for Payer: UHC Core |
$2,887.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.40
|
| Rate for Payer: UHC Exchange |
$864.40
|
| Rate for Payer: UHC Medicare Advantage |
$864.40
|
| Rate for Payer: UHCCP Medicaid |
$3,601.14
|
| Rate for Payer: VA VA |
$864.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.20
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
OP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$37.59 |
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna Medicare |
$10.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.05
|
| Rate for Payer: BCBS Complete |
$16.71
|
| Rate for Payer: BCBS MAPPO |
$10.44
|
| Rate for Payer: BCBS Trust/PPO |
$34.34
|
| Rate for Payer: BCN Commercial |
$32.48
|
| Rate for Payer: BCN Medicare Advantage |
$10.44
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$37.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: PACE Senior Care Partners |
$9.92
|
| Rate for Payer: PACE SWMI |
$10.44
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: PHP Medicare Advantage |
$10.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.15
|
| Rate for Payer: Priority Health HMO/PPO |
$36.34
|
| Rate for Payer: Priority Health Medicare |
$10.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$10.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.76
|
| Rate for Payer: UHC Core |
$34.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.44
|
| Rate for Payer: UHC Exchange |
$10.44
|
| Rate for Payer: UHC Medicare Advantage |
$10.44
|
| Rate for Payer: VA VA |
$10.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.33
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
IP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$37.59 |
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: BCBS Trust/PPO |
$34.10
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Healthscope Commercial |
$37.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.15
|
| Rate for Payer: Priority Health HMO/PPO |
$36.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.76
|
| Rate for Payer: UHC Core |
$34.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.33
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
OP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$283.81 |
| Max. Negotiated Rate |
$1,075.50 |
| Rate for Payer: Aetna Commercial |
$1,015.75
|
| Rate for Payer: Aetna Medicare |
$310.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$373.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$373.44
|
| Rate for Payer: BCBS Complete |
$478.00
|
| Rate for Payer: BCBS MAPPO |
$298.75
|
| Rate for Payer: BCBS Trust/PPO |
$982.41
|
| Rate for Payer: BCN Commercial |
$929.11
|
| Rate for Payer: BCN Medicare Advantage |
$298.75
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.75
|
| Rate for Payer: Healthscope Commercial |
$1,075.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$896.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.75
|
| Rate for Payer: Nomi Health Commercial |
$979.90
|
| Rate for Payer: PACE Senior Care Partners |
$283.81
|
| Rate for Payer: PACE SWMI |
$298.75
|
| Rate for Payer: PHP Commercial |
$1,015.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.65
|
| Rate for Payer: Priority Health Medicare |
$301.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.65
|
| Rate for Payer: Railroad Medicare Medicare |
$298.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.60
|
| Rate for Payer: UHC Core |
$997.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.75
|
| Rate for Payer: UHC Exchange |
$298.75
|
| Rate for Payer: UHC Medicare Advantage |
$298.75
|
| Rate for Payer: VA VA |
$298.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$896.25
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
IP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$776.75 |
| Max. Negotiated Rate |
$1,075.50 |
| Rate for Payer: Aetna Commercial |
$1,015.75
|
| Rate for Payer: BCBS Trust/PPO |
$975.48
|
| Rate for Payer: BCN Commercial |
$923.50
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,075.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$896.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.75
|
| Rate for Payer: Nomi Health Commercial |
$979.90
|
| Rate for Payer: PHP Commercial |
$1,015.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.60
|
| Rate for Payer: UHC Core |
$997.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$896.25
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: BCBS Trust/PPO |
$132.49
|
| Rate for Payer: BCN Commercial |
$125.43
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.50
|
| Rate for Payer: Priority Health HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: Aetna Medicare |
$42.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.72
|
| Rate for Payer: BCBS Complete |
$64.92
|
| Rate for Payer: BCBS MAPPO |
$40.58
|
| Rate for Payer: BCBS Trust/PPO |
$133.43
|
| Rate for Payer: BCN Commercial |
$126.19
|
| Rate for Payer: BCN Medicare Advantage |
$40.58
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.58
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: PACE Senior Care Partners |
$38.55
|
| Rate for Payer: PACE SWMI |
$40.58
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: PHP Medicare Advantage |
$40.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.50
|
| Rate for Payer: Priority Health HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Medicare |
$40.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.74
|
| Rate for Payer: Railroad Medicare Medicare |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.58
|
| Rate for Payer: UHC Exchange |
$40.58
|
| Rate for Payer: UHC Medicare Advantage |
$40.58
|
| Rate for Payer: VA VA |
$40.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
OP
|
$337.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.16 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: Aetna Medicare |
$87.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.47
|
| Rate for Payer: BCBS Complete |
$135.00
|
| Rate for Payer: BCBS MAPPO |
$84.38
|
| Rate for Payer: BCBS Trust/PPO |
$277.46
|
| Rate for Payer: BCN Commercial |
$262.41
|
| Rate for Payer: BCN Medicare Advantage |
$84.38
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.38
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: PACE Senior Care Partners |
$80.16
|
| Rate for Payer: PACE SWMI |
$84.38
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: PHP Medicare Advantage |
$84.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: Priority Health HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Medicare |
$85.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.12
|
| Rate for Payer: Railroad Medicare Medicare |
$84.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.38
|
| Rate for Payer: UHC Exchange |
$84.38
|
| Rate for Payer: UHC Medicare Advantage |
$84.38
|
| Rate for Payer: VA VA |
$84.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
IP
|
$337.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.38 |
| Max. Negotiated Rate |
$303.75 |
| Rate for Payer: Aetna Commercial |
$286.88
|
| Rate for Payer: BCBS Trust/PPO |
$275.50
|
| Rate for Payer: BCN Commercial |
$260.82
|
| Rate for Payer: Cash Price |
$270.00
|
| Rate for Payer: Cofinity Commercial |
$290.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.00
|
| Rate for Payer: Healthscope Commercial |
$303.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.88
|
| Rate for Payer: Nomi Health Commercial |
$276.75
|
| Rate for Payer: PHP Commercial |
$286.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.38
|
| Rate for Payer: Priority Health HMO/PPO |
$293.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.00
|
| Rate for Payer: UHC Core |
$281.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.12
|
|
|
HC INTRO SHEATH NON GUIDE LVL 4
|
Facility
|
IP
|
$485.16
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$315.35 |
| Max. Negotiated Rate |
$436.64 |
| Rate for Payer: Aetna Commercial |
$412.39
|
| Rate for Payer: BCBS Trust/PPO |
$396.04
|
| Rate for Payer: BCN Commercial |
$374.93
|
| Rate for Payer: Cash Price |
$388.13
|
| Rate for Payer: Cofinity Commercial |
$417.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.13
|
| Rate for Payer: Healthscope Commercial |
$436.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.39
|
| Rate for Payer: Nomi Health Commercial |
$397.83
|
| Rate for Payer: PHP Commercial |
$412.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.35
|
| Rate for Payer: Priority Health HMO/PPO |
$422.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.94
|
| Rate for Payer: UHC Core |
$405.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.87
|
|
|
HC INTRO SHEATH NON GUIDE LVL 4
|
Facility
|
OP
|
$485.16
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.23 |
| Max. Negotiated Rate |
$436.64 |
| Rate for Payer: Aetna Commercial |
$412.39
|
| Rate for Payer: Aetna Medicare |
$126.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.61
|
| Rate for Payer: BCBS Complete |
$194.06
|
| Rate for Payer: BCBS MAPPO |
$121.29
|
| Rate for Payer: BCBS Trust/PPO |
$398.85
|
| Rate for Payer: BCN Commercial |
$377.21
|
| Rate for Payer: BCN Medicare Advantage |
$121.29
|
| Rate for Payer: Cash Price |
$388.13
|
| Rate for Payer: Cofinity Commercial |
$417.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.29
|
| Rate for Payer: Healthscope Commercial |
$436.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.39
|
| Rate for Payer: Nomi Health Commercial |
$397.83
|
| Rate for Payer: PACE Senior Care Partners |
$115.23
|
| Rate for Payer: PACE SWMI |
$121.29
|
| Rate for Payer: PHP Commercial |
$412.39
|
| Rate for Payer: PHP Medicare Advantage |
$121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.35
|
| Rate for Payer: Priority Health HMO/PPO |
$422.09
|
| Rate for Payer: Priority Health Medicare |
$122.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.06
|
| Rate for Payer: Railroad Medicare Medicare |
$121.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.94
|
| Rate for Payer: UHC Core |
$405.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.29
|
| Rate for Payer: UHC Exchange |
$121.29
|
| Rate for Payer: UHC Medicare Advantage |
$121.29
|
| Rate for Payer: VA VA |
$121.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.87
|
|
|
HC IODINE, S
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100687
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC IODINE, S
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100687
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$15.60
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.60
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.60
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.60
|
| Rate for Payer: UHC Exchange |
$15.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.60
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$15.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC IOFLUPANE I-123 PER STUDY
|
Facility
|
IP
|
$5,436.63
|
|
|
Service Code
|
HCPCS A9584
|
| Hospital Charge Code |
34300035
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,533.81 |
| Max. Negotiated Rate |
$4,892.97 |
| Rate for Payer: Aetna Commercial |
$4,621.14
|
| Rate for Payer: BCBS Trust/PPO |
$4,437.92
|
| Rate for Payer: BCN Commercial |
$4,201.43
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cofinity Commercial |
$4,675.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,349.30
|
| Rate for Payer: Healthscope Commercial |
$4,892.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,077.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,621.14
|
| Rate for Payer: Nomi Health Commercial |
$4,458.04
|
| Rate for Payer: PHP Commercial |
$4,621.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,533.81
|
| Rate for Payer: Priority Health HMO/PPO |
$4,729.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,642.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,784.23
|
| Rate for Payer: UHC Core |
$4,539.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,077.47
|
|
|
HC IOFLUPANE I-123 PER STUDY
|
Facility
|
OP
|
$5,436.63
|
|
|
Service Code
|
HCPCS A9584
|
| Hospital Charge Code |
34300035
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,003.54 |
| Max. Negotiated Rate |
$4,892.97 |
| Rate for Payer: Aetna Commercial |
$4,621.14
|
| Rate for Payer: Aetna Medicare |
$1,413.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,698.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,698.95
|
| Rate for Payer: BCBS Complete |
$1,053.78
|
| Rate for Payer: BCBS MAPPO |
$1,359.16
|
| Rate for Payer: BCBS Trust/PPO |
$4,469.45
|
| Rate for Payer: BCN Commercial |
$4,226.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,359.16
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cash Price |
$4,349.30
|
| Rate for Payer: Cofinity Commercial |
$4,675.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,349.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,359.16
|
| Rate for Payer: Healthscope Commercial |
$4,892.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,077.47
|
| Rate for Payer: Mclaren Medicaid |
$1,003.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,427.12
|
| Rate for Payer: Meridian Medicaid |
$1,053.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,563.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,621.14
|
| Rate for Payer: Nomi Health Commercial |
$4,458.04
|
| Rate for Payer: PACE Senior Care Partners |
$1,291.20
|
| Rate for Payer: PACE SWMI |
$1,359.16
|
| Rate for Payer: PHP Commercial |
$4,621.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,359.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,003.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,533.81
|
| Rate for Payer: Priority Health HMO/PPO |
$4,729.87
|
| Rate for Payer: Priority Health Medicare |
$1,372.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,642.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,359.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,784.23
|
| Rate for Payer: UHC Core |
$4,539.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,359.16
|
| Rate for Payer: UHC Exchange |
$1,359.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,359.16
|
| Rate for Payer: UHCCP Medicaid |
$1,003.54
|
| Rate for Payer: VA VA |
$1,359.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,077.47
|
|
|
HC IOM EEG CAROTID ENDARTERECTOMY
|
Facility
|
IP
|
$1,297.89
|
|
|
Service Code
|
CPT 95955
|
| Hospital Charge Code |
74000014
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$843.63 |
| Max. Negotiated Rate |
$1,168.10 |
| Rate for Payer: Aetna Commercial |
$1,103.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,059.47
|
| Rate for Payer: BCN Commercial |
$1,003.01
|
| Rate for Payer: Cash Price |
$1,038.31
|
| Rate for Payer: Cofinity Commercial |
$1,116.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,038.31
|
| Rate for Payer: Healthscope Commercial |
$1,168.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$973.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,103.21
|
| Rate for Payer: Nomi Health Commercial |
$1,064.27
|
| Rate for Payer: PHP Commercial |
$1,103.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,129.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$869.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,142.14
|
| Rate for Payer: UHC Core |
$1,083.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$973.42
|
|
