|
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 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 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 |
$439.17
|
| Rate for Payer: BCBS MAPPO |
$143.31
|
| Rate for Payer: BCBS Trust/PPO |
$471.28
|
| Rate for Payer: BCN Commercial |
$445.71
|
| Rate for Payer: BCN Medicare Advantage |
$143.31
|
| 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 |
$143.31
|
| Rate for Payer: Healthscope Commercial |
$515.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.94
|
| Rate for Payer: Mclaren Medicaid |
$418.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.48
|
| Rate for Payer: Meridian Medicaid |
$439.17
|
| 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 |
$143.31
|
| Rate for Payer: PHP Commercial |
$487.27
|
| Rate for Payer: PHP Medicare Advantage |
$143.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.23
|
| 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 |
$143.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.47
|
| Rate for Payer: UHC Core |
$478.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.31
|
| Rate for Payer: UHC Exchange |
$143.31
|
| Rate for Payer: UHC Medicare Advantage |
$143.31
|
| Rate for Payer: UHCCP Medicaid |
$418.23
|
| Rate for Payer: VA VA |
$143.31
|
| 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 |
$439.17 |
| 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 |
$439.17
|
| 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 |
$418.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.70
|
| Rate for Payer: Meridian Medicaid |
$439.17
|
| 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 |
$418.23
|
| 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 |
$418.23
|
| 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
|
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 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 |
$302.95
|
| 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 |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.28
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| 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 |
$288.51
|
| 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 |
$288.51
|
| Rate for Payer: VA VA |
$121.22
|
| 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 |
$73.19
|
| Rate for Payer: BCBS Trust/PPO |
$240.66
|
| Rate for Payer: BCN Commercial |
$227.61
|
| Rate for Payer: BCN Medicare Advantage |
$73.19
|
| 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 |
$73.19
|
| 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 |
$73.19
|
| Rate for Payer: PHP Commercial |
$248.83
|
| Rate for Payer: PHP Medicare Advantage |
$73.19
|
| 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 |
$73.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.61
|
| Rate for Payer: UHC Core |
$244.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.19
|
| Rate for Payer: UHC Exchange |
$73.19
|
| Rate for Payer: UHC Medicare Advantage |
$73.19
|
| Rate for Payer: VA VA |
$73.19
|
| 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
|
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 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 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 |
$5,760.89 |
| 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 |
$5,760.89
|
| 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 |
$5,486.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$988.90
|
| Rate for Payer: Meridian Medicaid |
$5,760.89
|
| 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 |
$5,486.20
|
| 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 |
$5,486.20
|
| 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
|
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
|
|
|
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 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 |
$224.69
|
| 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 |
$224.69
|
|
|
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 |
$74.89
|
| Rate for Payer: BCBS Trust/PPO |
$246.28
|
| Rate for Payer: BCN Commercial |
$232.92
|
| Rate for Payer: BCN Medicare Advantage |
$74.89
|
| 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 |
$74.89
|
| Rate for Payer: Healthscope Commercial |
$269.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.69
|
| 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 |
$74.89
|
| Rate for Payer: PHP Commercial |
$254.64
|
| Rate for Payer: PHP Medicare Advantage |
$74.89
|
| 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 |
$74.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.63
|
| Rate for Payer: UHC Core |
$250.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.89
|
| Rate for Payer: UHC Exchange |
$74.89
|
| Rate for Payer: UHC Medicare Advantage |
$74.89
|
| Rate for Payer: VA VA |
$74.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.69
|
|
|
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 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 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
|
OP
|
$3,457.60
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$821.18 |
| Max. Negotiated Rate |
$3,859.48 |
| 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 |
$3,859.48
|
| 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 |
$3,675.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$907.62
|
| Rate for Payer: Meridian Medicaid |
$3,859.48
|
| 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 |
$3,675.46
|
| 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 |
$3,675.46
|
| Rate for Payer: VA VA |
$864.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.20
|
|
