|
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
|
|
|
HC IOM INTRAOPERATIVE MONITOR/15 MINUTES
|
Facility
|
OP
|
$187.07
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
74000017
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$44.43 |
| Max. Negotiated Rate |
$168.36 |
| Rate for Payer: Aetna Commercial |
$159.01
|
| Rate for Payer: Aetna Medicare |
$48.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.46
|
| Rate for Payer: BCBS Complete |
$74.83
|
| Rate for Payer: BCBS MAPPO |
$46.77
|
| Rate for Payer: BCBS Trust/PPO |
$153.79
|
| Rate for Payer: BCN Commercial |
$145.45
|
| Rate for Payer: BCN Medicare Advantage |
$46.77
|
| Rate for Payer: Cash Price |
$149.66
|
| Rate for Payer: Cofinity Commercial |
$160.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.77
|
| Rate for Payer: Healthscope Commercial |
$168.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.01
|
| Rate for Payer: Nomi Health Commercial |
$153.40
|
| Rate for Payer: PACE Senior Care Partners |
$44.43
|
| Rate for Payer: PACE SWMI |
$46.77
|
| Rate for Payer: PHP Commercial |
$159.01
|
| Rate for Payer: PHP Medicare Advantage |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.60
|
| Rate for Payer: Priority Health HMO/PPO |
$162.75
|
| Rate for Payer: Priority Health Medicare |
$47.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.34
|
| Rate for Payer: Railroad Medicare Medicare |
$46.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.62
|
| Rate for Payer: UHC Core |
$156.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.77
|
| Rate for Payer: UHC Exchange |
$46.77
|
| Rate for Payer: UHC Medicare Advantage |
$46.77
|
| Rate for Payer: VA VA |
$46.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.30
|
|
|
HC IOM INTRAOPERATIVE MONITOR/15 MINUTES
|
Facility
|
IP
|
$187.07
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
74000017
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$168.36 |
| Rate for Payer: Aetna Commercial |
$159.01
|
| Rate for Payer: BCBS Trust/PPO |
$152.71
|
| Rate for Payer: BCN Commercial |
$144.57
|
| Rate for Payer: Cash Price |
$149.66
|
| Rate for Payer: Cofinity Commercial |
$160.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.66
|
| Rate for Payer: Healthscope Commercial |
$168.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.01
|
| Rate for Payer: Nomi Health Commercial |
$153.40
|
| Rate for Payer: PHP Commercial |
$159.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.60
|
| Rate for Payer: Priority Health HMO/PPO |
$162.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.62
|
| Rate for Payer: UHC Core |
$156.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.30
|
|
|
HC IOM STD PRASS PROBE
|
Facility
|
OP
|
$357.38
|
|
| Hospital Charge Code |
62200008
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$84.88 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$92.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.68
|
| Rate for Payer: BCBS Complete |
$142.95
|
| Rate for Payer: BCBS MAPPO |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.80
|
| Rate for Payer: BCN Commercial |
$277.86
|
| Rate for Payer: BCN Medicare Advantage |
$89.34
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.34
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$84.88
|
| Rate for Payer: PACE SWMI |
$89.34
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Medicare |
$90.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: Railroad Medicare Medicare |
$89.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.34
|
| Rate for Payer: UHC Exchange |
$89.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.34
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IOM STD PRASS PROBE
|
Facility
|
IP
|
$357.38
|
|
| Hospital Charge Code |
62200008
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: BCBS Trust/PPO |
$291.73
|
| Rate for Payer: BCN Commercial |
$276.18
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IOM SUBDERMAL RECORDING ELECTR
|
Facility
|
IP
|
$15.36
|
|
| Hospital Charge Code |
62200009
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$13.82 |
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$12.54
|
| Rate for Payer: BCN Commercial |
$11.87
|
| Rate for Payer: Cash Price |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$13.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Nomi Health Commercial |
$12.60
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.98
|
| Rate for Payer: Priority Health HMO/PPO |
$13.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.52
|
| Rate for Payer: UHC Core |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.52
|
|
|
HC IOM SUBDERMAL RECORDING ELECTR
|
Facility
|
OP
|
$15.36
|
|
| Hospital Charge Code |
62200009
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$13.82 |
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Medicare |
$3.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.80
|
| Rate for Payer: BCBS Complete |
$6.14
|
| Rate for Payer: BCBS MAPPO |
$3.84
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCN Commercial |
$11.94
|
| Rate for Payer: BCN Medicare Advantage |
$3.84
|
| Rate for Payer: Cash Price |
$12.29
|
| Rate for Payer: Cofinity Commercial |
$13.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.84
|
| Rate for Payer: Healthscope Commercial |
$13.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.06
|
| Rate for Payer: Nomi Health Commercial |
$12.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.65
|
| Rate for Payer: PACE SWMI |
$3.84
|
| Rate for Payer: PHP Commercial |
$13.06
|
| Rate for Payer: PHP Medicare Advantage |
$3.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.98
|
| Rate for Payer: Priority Health HMO/PPO |
$13.36
|
| Rate for Payer: Priority Health Medicare |
$3.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.29
|
| Rate for Payer: Railroad Medicare Medicare |
$3.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.52
|
| Rate for Payer: UHC Core |
$12.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.84
|
| Rate for Payer: UHC Exchange |
$3.84
|
| Rate for Payer: UHC Medicare Advantage |
$3.84
|
| Rate for Payer: VA VA |
$3.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.52
|
|
|
HC IONIZED CALCIUM
|
Facility
|
IP
|
$107.51
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.88 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$91.38
|
| Rate for Payer: BCBS Trust/PPO |
$87.76
|
| Rate for Payer: BCN Commercial |
$83.08
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cofinity Commercial |
$92.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.01
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.38
|
| Rate for Payer: Nomi Health Commercial |
$88.16
|
| Rate for Payer: PHP Commercial |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.88
|
| Rate for Payer: Priority Health HMO/PPO |
$93.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.61
|
| Rate for Payer: UHC Core |
$89.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.63
|
|
|
HC IONIZED CALCIUM
|
Facility
|
OP
|
$107.51
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.89 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$91.38
|
| Rate for Payer: Aetna Medicare |
$27.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.60
|
| Rate for Payer: BCBS Complete |
$10.39
|
| Rate for Payer: BCBS MAPPO |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$88.38
|
| Rate for Payer: BCN Commercial |
$83.59
|
| Rate for Payer: BCN Medicare Advantage |
$26.88
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cofinity Commercial |
$92.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.88
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.63
|
| Rate for Payer: Mclaren Medicaid |
$9.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.22
|
| Rate for Payer: Meridian Medicaid |
$10.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.38
|
| Rate for Payer: Nomi Health Commercial |
$88.16
|
| Rate for Payer: PACE Senior Care Partners |
$25.53
|
| Rate for Payer: PACE SWMI |
$26.88
|
| Rate for Payer: PHP Commercial |
$91.38
|
| Rate for Payer: PHP Medicare Advantage |
$26.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.88
|
| Rate for Payer: Priority Health HMO/PPO |
$93.53
|
| Rate for Payer: Priority Health Medicare |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.03
|
| Rate for Payer: Railroad Medicare Medicare |
$26.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.61
|
| Rate for Payer: UHC Core |
$89.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.88
|
| Rate for Payer: UHC Exchange |
$26.88
|
| Rate for Payer: UHC Medicare Advantage |
$26.88
|
| Rate for Payer: UHCCP Medicaid |
$9.89
|
| Rate for Payer: VA VA |
$26.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.63
|
|
|
HC IONTOPHORESIS EACH 15 MIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.98 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$86.63
|
| Rate for Payer: BCN Commercial |
$82.01
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC IONTOPHORESIS EACH 15 MIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$42.45
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$82.51
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.53
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
OP
|
$969.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$230.14 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$251.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.81
|
| Rate for Payer: BCBS Complete |
$387.60
|
| Rate for Payer: BCBS MAPPO |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$796.61
|
| Rate for Payer: BCN Commercial |
$753.40
|
| Rate for Payer: BCN Medicare Advantage |
$242.25
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.25
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$794.58
|
| Rate for Payer: PACE Senior Care Partners |
$230.14
|
| Rate for Payer: PACE SWMI |
$242.25
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO |
$843.03
|
| Rate for Payer: Priority Health Medicare |
$244.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.23
|
| Rate for Payer: Railroad Medicare Medicare |
$242.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.25
|
| Rate for Payer: UHC Exchange |
$242.25
|
| Rate for Payer: UHC Medicare Advantage |
$242.25
|
| Rate for Payer: VA VA |
$242.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
IP
|
$969.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$629.85 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: BCBS Trust/PPO |
$790.99
|
| Rate for Payer: BCN Commercial |
$748.84
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$794.58
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO |
$843.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$230.14 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$251.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.81
|
| Rate for Payer: BCBS Complete |
$520.48
|
| Rate for Payer: BCBS MAPPO |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$796.61
|
| Rate for Payer: BCN Commercial |
$753.40
|
| Rate for Payer: BCN Medicare Advantage |
$242.25
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.25
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Mclaren Medicaid |
$495.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.36
|
| Rate for Payer: Meridian Medicaid |
$520.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$794.58
|
| Rate for Payer: PACE Senior Care Partners |
$230.14
|
| Rate for Payer: PACE SWMI |
$242.25
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$242.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO |
$843.03
|
| Rate for Payer: Priority Health Medicare |
$244.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.23
|
| Rate for Payer: Railroad Medicare Medicare |
$242.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.25
|
| Rate for Payer: UHC Exchange |
$242.25
|
| Rate for Payer: UHC Medicare Advantage |
$242.25
|
| Rate for Payer: UHCCP Medicaid |
$495.67
|
| Rate for Payer: VA VA |
$242.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$629.85 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: BCBS Trust/PPO |
$790.99
|
| Rate for Payer: BCN Commercial |
$748.84
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$794.58
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO |
$843.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$649.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.72
|
| Rate for Payer: UHC Core |
$809.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
IP
|
$138.64
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$90.12 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna Commercial |
$117.84
|
| Rate for Payer: BCBS Trust/PPO |
$113.17
|
| Rate for Payer: BCN Commercial |
$107.14
|
| Rate for Payer: Cash Price |
$110.91
|
| Rate for Payer: Cofinity Commercial |
$119.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.91
|
| Rate for Payer: Healthscope Commercial |
$124.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.84
|
| Rate for Payer: Nomi Health Commercial |
$113.68
|
| Rate for Payer: PHP Commercial |
$117.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.12
|
| Rate for Payer: Priority Health HMO/PPO |
$120.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.00
|
| Rate for Payer: UHC Core |
$115.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.98
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
OP
|
$138.64
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$32.93 |
| Max. Negotiated Rate |
$151.29 |
| Rate for Payer: Aetna Commercial |
$117.84
|
| Rate for Payer: Aetna Medicare |
$36.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.32
|
| Rate for Payer: BCBS Complete |
$151.29
|
| Rate for Payer: BCBS MAPPO |
$34.66
|
| Rate for Payer: BCBS Trust/PPO |
$113.98
|
| Rate for Payer: BCN Commercial |
$107.79
|
| Rate for Payer: BCN Medicare Advantage |
$34.66
|
| Rate for Payer: Cash Price |
$110.91
|
| Rate for Payer: Cash Price |
$110.91
|
| Rate for Payer: Cofinity Commercial |
$119.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.66
|
| Rate for Payer: Healthscope Commercial |
$124.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.98
|
| Rate for Payer: Mclaren Medicaid |
$144.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.39
|
| Rate for Payer: Meridian Medicaid |
$151.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.84
|
| Rate for Payer: Nomi Health Commercial |
$113.68
|
| Rate for Payer: PACE Senior Care Partners |
$32.93
|
| Rate for Payer: PACE SWMI |
$34.66
|
| Rate for Payer: PHP Commercial |
$117.84
|
| Rate for Payer: PHP Medicare Advantage |
$34.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.12
|
| Rate for Payer: Priority Health HMO/PPO |
$120.62
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.89
|
| Rate for Payer: Railroad Medicare Medicare |
$34.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.00
|
| Rate for Payer: UHC Core |
$115.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.66
|
| Rate for Payer: UHC Exchange |
$34.66
|
| Rate for Payer: UHC Medicare Advantage |
$34.66
|
| Rate for Payer: UHCCP Medicaid |
$144.08
|
| Rate for Payer: VA VA |
$34.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.98
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
IP
|
$4.16
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$3.40
|
| Rate for Payer: BCN Commercial |
$3.21
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.41
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
OP
|
$4.16
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.99 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna Medicare |
$1.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.30
|
| Rate for Payer: BCBS Complete |
$1.66
|
| Rate for Payer: BCBS MAPPO |
$1.04
|
| Rate for Payer: BCBS Trust/PPO |
$3.42
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Medicare Advantage |
$1.04
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.04
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.41
|
| Rate for Payer: PACE Senior Care Partners |
$0.99
|
| Rate for Payer: PACE SWMI |
$1.04
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$1.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3.62
|
| Rate for Payer: Priority Health Medicare |
$1.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$3.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.04
|
| Rate for Payer: UHC Exchange |
$1.04
|
| Rate for Payer: UHC Medicare Advantage |
$1.04
|
| Rate for Payer: VA VA |
$1.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
IP
|
$878.12
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$570.78 |
| Max. Negotiated Rate |
$790.31 |
| Rate for Payer: Aetna Commercial |
$746.40
|
| Rate for Payer: BCBS Trust/PPO |
$716.81
|
| Rate for Payer: BCN Commercial |
$678.61
|
| Rate for Payer: Cash Price |
$702.50
|
| Rate for Payer: Cofinity Commercial |
$755.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.50
|
| Rate for Payer: Healthscope Commercial |
$790.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.40
|
| Rate for Payer: Nomi Health Commercial |
$720.06
|
| Rate for Payer: PHP Commercial |
$746.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.78
|
| Rate for Payer: Priority Health HMO/PPO |
$763.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.75
|
| Rate for Payer: UHC Core |
$733.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.59
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
OP
|
$878.12
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$208.55 |
| Max. Negotiated Rate |
$790.31 |
| Rate for Payer: Aetna Commercial |
$746.40
|
| Rate for Payer: Aetna Medicare |
$228.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.41
|
| Rate for Payer: BCBS Complete |
$351.25
|
| Rate for Payer: BCBS MAPPO |
$219.53
|
| Rate for Payer: BCBS Trust/PPO |
$721.90
|
| Rate for Payer: BCN Commercial |
$682.74
|
| Rate for Payer: BCN Medicare Advantage |
$219.53
|
| Rate for Payer: Cash Price |
$702.50
|
| Rate for Payer: Cofinity Commercial |
$755.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.53
|
| Rate for Payer: Healthscope Commercial |
$790.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.40
|
| Rate for Payer: Nomi Health Commercial |
$720.06
|
| Rate for Payer: PACE Senior Care Partners |
$208.55
|
| Rate for Payer: PACE SWMI |
$219.53
|
| Rate for Payer: PHP Commercial |
$746.40
|
| Rate for Payer: PHP Medicare Advantage |
$219.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.78
|
| Rate for Payer: Priority Health HMO/PPO |
$763.96
|
| Rate for Payer: Priority Health Medicare |
$221.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.34
|
| Rate for Payer: Railroad Medicare Medicare |
$219.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.75
|
| Rate for Payer: UHC Core |
$733.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.53
|
| Rate for Payer: UHC Exchange |
$219.53
|
| Rate for Payer: UHC Medicare Advantage |
$219.53
|
| Rate for Payer: VA VA |
$219.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.59
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$407.85 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
OP
|
$1,716.86
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$407.75 |
| Max. Negotiated Rate |
$2,341.27 |
| Rate for Payer: Aetna Commercial |
$1,459.33
|
| Rate for Payer: Aetna Medicare |
$446.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$536.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$536.52
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$429.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,411.43
|
| Rate for Payer: BCN Commercial |
$1,334.86
|
| Rate for Payer: BCN Medicare Advantage |
$429.22
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cofinity Commercial |
$1,476.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$429.22
|
| Rate for Payer: Healthscope Commercial |
$1,545.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,287.64
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.68
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$493.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.33
|
| Rate for Payer: Nomi Health Commercial |
$1,407.83
|
| Rate for Payer: PACE Senior Care Partners |
$407.75
|
| Rate for Payer: PACE SWMI |
$429.22
|
| Rate for Payer: PHP Commercial |
$1,459.33
|
| Rate for Payer: PHP Medicare Advantage |
$429.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.67
|
| Rate for Payer: Priority Health Medicare |
$433.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.30
|
| Rate for Payer: Railroad Medicare Medicare |
$429.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.84
|
| Rate for Payer: UHC Core |
$1,433.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$429.22
|
| Rate for Payer: UHC Exchange |
$429.22
|
| Rate for Payer: UHC Medicare Advantage |
$429.22
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$429.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,287.64
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,716.86
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,115.96 |
| Max. Negotiated Rate |
$1,545.17 |
| Rate for Payer: Aetna Commercial |
$1,459.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.47
|
| Rate for Payer: BCN Commercial |
$1,326.79
|
| Rate for Payer: Cash Price |
$1,373.49
|
| Rate for Payer: Cofinity Commercial |
$1,476.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.49
|
| Rate for Payer: Healthscope Commercial |
$1,545.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,287.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.33
|
| Rate for Payer: Nomi Health Commercial |
$1,407.83
|
| Rate for Payer: PHP Commercial |
$1,459.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.84
|
| Rate for Payer: UHC Core |
$1,433.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,287.64
|
|
