|
HC IR ATHERECT STENT TIB PERON UN
|
Facility
|
IP
|
$20,088.35
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
36100175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,057.43 |
| Max. Negotiated Rate |
$18,079.52 |
| Rate for Payer: Aetna Commercial |
$17,075.10
|
| Rate for Payer: BCBS Trust/PPO |
$16,398.12
|
| Rate for Payer: BCN Commercial |
$15,524.28
|
| Rate for Payer: Cash Price |
$16,070.68
|
| Rate for Payer: Cofinity Commercial |
$17,275.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,070.68
|
| Rate for Payer: Healthscope Commercial |
$18,079.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,066.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,075.10
|
| Rate for Payer: Nomi Health Commercial |
$16,472.45
|
| Rate for Payer: PHP Commercial |
$17,075.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,057.43
|
| Rate for Payer: Priority Health HMO/PPO |
$17,476.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,459.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,677.75
|
| Rate for Payer: UHC Core |
$16,773.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,066.26
|
|
|
HC IR CATHETER
|
Facility
|
IP
|
$44.74
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.52
|
| Rate for Payer: BCN Commercial |
$34.58
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.56
|
|
|
HC IR CATHETER
|
Facility
|
OP
|
$44.74
|
|
| Hospital Charge Code |
27200307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.98
|
| Rate for Payer: BCBS Complete |
$17.90
|
| Rate for Payer: BCBS MAPPO |
$11.18
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$34.79
|
| Rate for Payer: BCN Medicare Advantage |
$11.18
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.18
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.18
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.18
|
| Rate for Payer: UHC Exchange |
$11.18
|
| Rate for Payer: UHC Medicare Advantage |
$11.18
|
| Rate for Payer: VA VA |
$11.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.56
|
|
|
HC IR CATHETER.
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$60.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.15
|
| Rate for Payer: BCBS Complete |
$93.64
|
| Rate for Payer: BCBS MAPPO |
$58.52
|
| Rate for Payer: BCBS Trust/PPO |
$192.45
|
| Rate for Payer: BCN Commercial |
$182.00
|
| Rate for Payer: BCN Medicare Advantage |
$58.52
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.52
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: PACE Senior Care Partners |
$55.60
|
| Rate for Payer: PACE SWMI |
$58.52
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: PHP Medicare Advantage |
$58.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Medicare |
$59.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.84
|
| Rate for Payer: Railroad Medicare Medicare |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.52
|
| Rate for Payer: UHC Exchange |
$58.52
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: VA VA |
$58.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR CATHETER.
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27200308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$191.09
|
| Rate for Payer: BCN Commercial |
$180.90
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
IP
|
$555.66
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$361.18 |
| Max. Negotiated Rate |
$500.09 |
| Rate for Payer: Aetna Commercial |
$472.31
|
| Rate for Payer: BCBS Trust/PPO |
$453.59
|
| Rate for Payer: BCN Commercial |
$429.41
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$477.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Healthscope Commercial |
$500.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: PHP Commercial |
$472.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.98
|
| Rate for Payer: UHC Core |
$463.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.74
|
|
|
HC IR CENTRAL LINE CHECK W FLUOROSCOPY
|
Facility
|
OP
|
$555.66
|
|
|
Service Code
|
CPT 36598
|
| Hospital Charge Code |
36100145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$131.97 |
| Max. Negotiated Rate |
$500.09 |
| Rate for Payer: Aetna Commercial |
$472.31
|
| Rate for Payer: Aetna Medicare |
$144.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.64
|
| Rate for Payer: BCBS Complete |
$156.72
|
| Rate for Payer: BCBS MAPPO |
$138.92
|
| Rate for Payer: BCBS Trust/PPO |
$456.81
|
| Rate for Payer: BCN Commercial |
$432.03
|
| Rate for Payer: BCN Medicare Advantage |
$138.92
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cash Price |
$444.53
|
| Rate for Payer: Cofinity Commercial |
$477.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$444.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.92
|
| Rate for Payer: Healthscope Commercial |
$500.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.74
|
| Rate for Payer: Mclaren Medicaid |
$149.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.86
|
| Rate for Payer: Meridian Medicaid |
$156.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$472.31
|
| Rate for Payer: Nomi Health Commercial |
$455.64
|
| Rate for Payer: PACE Senior Care Partners |
$131.97
|
| Rate for Payer: PACE SWMI |
$138.92
|
| Rate for Payer: PHP Commercial |
$472.31
|
| Rate for Payer: PHP Medicare Advantage |
$138.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.18
|
| Rate for Payer: Priority Health HMO/PPO |
$483.42
|
| Rate for Payer: Priority Health Medicare |
$140.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.29
|
| Rate for Payer: Railroad Medicare Medicare |
$138.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.98
|
| Rate for Payer: UHC Core |
$463.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.92
|
| Rate for Payer: UHC Exchange |
$138.92
|
| Rate for Payer: UHC Medicare Advantage |
$138.92
|
| Rate for Payer: UHCCP Medicaid |
$149.25
|
| Rate for Payer: VA VA |
$138.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.74
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
IP
|
$3,560.77
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,314.50 |
| Max. Negotiated Rate |
$3,204.69 |
| Rate for Payer: Aetna Commercial |
$3,026.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,906.66
|
| Rate for Payer: BCN Commercial |
$2,751.76
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cofinity Commercial |
$3,062.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.62
|
| Rate for Payer: Healthscope Commercial |
$3,204.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.65
|
| Rate for Payer: Nomi Health Commercial |
$2,919.83
|
| Rate for Payer: PHP Commercial |
$3,026.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,097.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,385.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,133.48
|
| Rate for Payer: UHC Core |
$2,973.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.58
|
|
|
HC IR CYSTOSTOMY WITH DRAINAGE
|
Facility
|
OP
|
$3,560.77
|
|
|
Service Code
|
CPT 51040
|
| Hospital Charge Code |
36100398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$845.68 |
| Max. Negotiated Rate |
$3,204.69 |
| Rate for Payer: Aetna Commercial |
$3,026.65
|
| Rate for Payer: Aetna Medicare |
$925.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,112.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,112.74
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$890.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,927.31
|
| Rate for Payer: BCN Commercial |
$2,768.50
|
| Rate for Payer: BCN Medicare Advantage |
$890.19
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cash Price |
$2,848.62
|
| Rate for Payer: Cofinity Commercial |
$3,062.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.19
|
| Rate for Payer: Healthscope Commercial |
$3,204.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.58
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.70
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,023.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.65
|
| Rate for Payer: Nomi Health Commercial |
$2,919.83
|
| Rate for Payer: PACE Senior Care Partners |
$845.68
|
| Rate for Payer: PACE SWMI |
$890.19
|
| Rate for Payer: PHP Commercial |
$3,026.65
|
| Rate for Payer: PHP Medicare Advantage |
$890.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.50
|
| Rate for Payer: Priority Health HMO/PPO |
$3,097.87
|
| Rate for Payer: Priority Health Medicare |
$899.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,385.72
|
| Rate for Payer: Railroad Medicare Medicare |
$890.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,133.48
|
| Rate for Payer: UHC Core |
$2,973.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.19
|
| Rate for Payer: UHC Exchange |
$890.19
|
| Rate for Payer: UHC Medicare Advantage |
$890.19
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$890.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.58
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
OP
|
$2,558.14
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$607.56 |
| Max. Negotiated Rate |
$2,302.33 |
| Rate for Payer: Aetna Commercial |
$2,174.42
|
| Rate for Payer: Aetna Medicare |
$665.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$799.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$799.42
|
| Rate for Payer: BCBS Complete |
$1,452.56
|
| Rate for Payer: BCBS MAPPO |
$639.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.05
|
| Rate for Payer: BCN Commercial |
$1,988.95
|
| Rate for Payer: BCN Medicare Advantage |
$639.54
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cofinity Commercial |
$2,200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,046.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.54
|
| Rate for Payer: Healthscope Commercial |
$2,302.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,918.60
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.51
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$735.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,174.42
|
| Rate for Payer: Nomi Health Commercial |
$2,097.67
|
| Rate for Payer: PACE Senior Care Partners |
$607.56
|
| Rate for Payer: PACE SWMI |
$639.54
|
| Rate for Payer: PHP Commercial |
$2,174.42
|
| Rate for Payer: PHP Medicare Advantage |
$639.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,225.58
|
| Rate for Payer: Priority Health Medicare |
$645.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,713.95
|
| Rate for Payer: Railroad Medicare Medicare |
$639.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,251.16
|
| Rate for Payer: UHC Core |
$2,136.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$639.54
|
| Rate for Payer: UHC Exchange |
$639.54
|
| Rate for Payer: UHC Medicare Advantage |
$639.54
|
| Rate for Payer: UHCCP Medicaid |
$1,383.30
|
| Rate for Payer: VA VA |
$639.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,918.60
|
|
|
HC IR DISKOGRAM CERVICAL THORACIC
|
Facility
|
IP
|
$2,558.14
|
|
|
Service Code
|
CPT 72285
|
| Hospital Charge Code |
32000057
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,662.79 |
| Max. Negotiated Rate |
$2,302.33 |
| Rate for Payer: Aetna Commercial |
$2,174.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,088.21
|
| Rate for Payer: BCN Commercial |
$1,976.93
|
| Rate for Payer: Cash Price |
$2,046.51
|
| Rate for Payer: Cofinity Commercial |
$2,200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,046.51
|
| Rate for Payer: Healthscope Commercial |
$2,302.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,918.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,174.42
|
| Rate for Payer: Nomi Health Commercial |
$2,097.67
|
| Rate for Payer: PHP Commercial |
$2,174.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,662.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,225.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,713.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,251.16
|
| Rate for Payer: UHC Core |
$2,136.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,918.60
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
OP
|
$2,929.03
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$695.64 |
| Max. Negotiated Rate |
$2,636.13 |
| Rate for Payer: Aetna Commercial |
$2,489.68
|
| Rate for Payer: Aetna Medicare |
$761.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$915.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$915.32
|
| Rate for Payer: BCBS Complete |
$1,452.56
|
| Rate for Payer: BCBS MAPPO |
$732.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,407.96
|
| Rate for Payer: BCN Commercial |
$2,277.32
|
| Rate for Payer: BCN Medicare Advantage |
$732.26
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cofinity Commercial |
$2,518.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,343.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.26
|
| Rate for Payer: Healthscope Commercial |
$2,636.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,196.77
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$768.87
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$842.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,401.80
|
| Rate for Payer: PACE Senior Care Partners |
$695.64
|
| Rate for Payer: PACE SWMI |
$732.26
|
| Rate for Payer: PHP Commercial |
$2,489.68
|
| Rate for Payer: PHP Medicare Advantage |
$732.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,548.26
|
| Rate for Payer: Priority Health Medicare |
$739.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,962.45
|
| Rate for Payer: Railroad Medicare Medicare |
$732.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,577.55
|
| Rate for Payer: UHC Core |
$2,445.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.26
|
| Rate for Payer: UHC Exchange |
$732.26
|
| Rate for Payer: UHC Medicare Advantage |
$732.26
|
| Rate for Payer: UHCCP Medicaid |
$1,383.30
|
| Rate for Payer: VA VA |
$732.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,196.77
|
|
|
HC IR DISKOGRAM LUMBAR ONLY
|
Facility
|
IP
|
$2,929.03
|
|
|
Service Code
|
CPT 72295
|
| Hospital Charge Code |
32000277
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,903.87 |
| Max. Negotiated Rate |
$2,636.13 |
| Rate for Payer: Aetna Commercial |
$2,489.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,390.97
|
| Rate for Payer: BCN Commercial |
$2,263.55
|
| Rate for Payer: Cash Price |
$2,343.22
|
| Rate for Payer: Cofinity Commercial |
$2,518.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,343.22
|
| Rate for Payer: Healthscope Commercial |
$2,636.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,196.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,401.80
|
| Rate for Payer: PHP Commercial |
$2,489.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,548.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,962.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,577.55
|
| Rate for Payer: UHC Core |
$2,445.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,196.77
|
|
|
HC IR EMBOLIZATION
|
Facility
|
IP
|
$3,499.53
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,274.69 |
| Max. Negotiated Rate |
$3,149.58 |
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,856.67
|
| Rate for Payer: BCN Commercial |
$2,704.44
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$2,869.61
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health HMO/PPO |
$3,044.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,344.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,079.59
|
| Rate for Payer: UHC Core |
$2,922.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IR EMBOLIZATION
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
32000210
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$831.14 |
| Max. Negotiated Rate |
$3,149.58 |
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna Medicare |
$909.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,093.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,093.60
|
| Rate for Payer: BCBS Complete |
$1,399.81
|
| Rate for Payer: BCBS MAPPO |
$874.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,876.96
|
| Rate for Payer: BCN Commercial |
$2,720.88
|
| Rate for Payer: BCN Medicare Advantage |
$874.88
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$874.88
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$918.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,006.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$2,869.61
|
| Rate for Payer: PACE Senior Care Partners |
$831.14
|
| Rate for Payer: PACE SWMI |
$874.88
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: PHP Medicare Advantage |
$874.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health HMO/PPO |
$3,044.59
|
| Rate for Payer: Priority Health Medicare |
$883.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,344.69
|
| Rate for Payer: Railroad Medicare Medicare |
$874.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,079.59
|
| Rate for Payer: UHC Core |
$2,922.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$874.88
|
| Rate for Payer: UHC Exchange |
$874.88
|
| Rate for Payer: UHC Medicare Advantage |
$874.88
|
| Rate for Payer: VA VA |
$874.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IR ERCP
|
Facility
|
IP
|
$816.66
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$530.83 |
| Max. Negotiated Rate |
$734.99 |
| Rate for Payer: Aetna Commercial |
$694.16
|
| Rate for Payer: BCBS Trust/PPO |
$666.64
|
| Rate for Payer: BCN Commercial |
$631.11
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$702.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Healthscope Commercial |
$734.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: PHP Commercial |
$694.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: Priority Health HMO/PPO |
$710.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.66
|
| Rate for Payer: UHC Core |
$681.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.50
|
|
|
HC IR ERCP
|
Facility
|
OP
|
$816.66
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
32000155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.96 |
| Max. Negotiated Rate |
$734.99 |
| Rate for Payer: Aetna Commercial |
$694.16
|
| Rate for Payer: Aetna Medicare |
$212.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.21
|
| Rate for Payer: BCBS Complete |
$326.66
|
| Rate for Payer: BCBS MAPPO |
$204.16
|
| Rate for Payer: BCBS Trust/PPO |
$671.38
|
| Rate for Payer: BCN Commercial |
$634.95
|
| Rate for Payer: BCN Medicare Advantage |
$204.16
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$702.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.16
|
| Rate for Payer: Healthscope Commercial |
$734.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: PACE Senior Care Partners |
$193.96
|
| Rate for Payer: PACE SWMI |
$204.16
|
| Rate for Payer: PHP Commercial |
$694.16
|
| Rate for Payer: PHP Medicare Advantage |
$204.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: Priority Health HMO/PPO |
$710.49
|
| Rate for Payer: Priority Health Medicare |
$206.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.16
|
| Rate for Payer: Railroad Medicare Medicare |
$204.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.66
|
| Rate for Payer: UHC Core |
$681.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.16
|
| Rate for Payer: UHC Exchange |
$204.16
|
| Rate for Payer: UHC Medicare Advantage |
$204.16
|
| Rate for Payer: VA VA |
$204.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.50
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
IP
|
$628.94
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$408.81 |
| Max. Negotiated Rate |
$566.05 |
| Rate for Payer: Aetna Commercial |
$534.60
|
| Rate for Payer: BCBS Trust/PPO |
$513.40
|
| Rate for Payer: BCN Commercial |
$486.04
|
| Rate for Payer: Cash Price |
$503.15
|
| Rate for Payer: Cofinity Commercial |
$540.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.15
|
| Rate for Payer: Healthscope Commercial |
$566.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.60
|
| Rate for Payer: Nomi Health Commercial |
$515.73
|
| Rate for Payer: PHP Commercial |
$534.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.81
|
| Rate for Payer: Priority Health HMO/PPO |
$547.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.47
|
| Rate for Payer: UHC Core |
$525.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.70
|
|
|
HC IR FIBRIN STRIPPING OF VAD
|
Facility
|
OP
|
$628.94
|
|
|
Service Code
|
CPT 75901
|
| Hospital Charge Code |
32000275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.37 |
| Max. Negotiated Rate |
$566.05 |
| Rate for Payer: Aetna Commercial |
$534.60
|
| Rate for Payer: Aetna Medicare |
$163.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.54
|
| Rate for Payer: BCBS Complete |
$251.58
|
| Rate for Payer: BCBS MAPPO |
$157.24
|
| Rate for Payer: BCBS Trust/PPO |
$517.05
|
| Rate for Payer: BCN Commercial |
$489.00
|
| Rate for Payer: BCN Medicare Advantage |
$157.24
|
| Rate for Payer: Cash Price |
$503.15
|
| Rate for Payer: Cofinity Commercial |
$540.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.24
|
| Rate for Payer: Healthscope Commercial |
$566.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.60
|
| Rate for Payer: Nomi Health Commercial |
$515.73
|
| Rate for Payer: PACE Senior Care Partners |
$149.37
|
| Rate for Payer: PACE SWMI |
$157.24
|
| Rate for Payer: PHP Commercial |
$534.60
|
| Rate for Payer: PHP Medicare Advantage |
$157.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.81
|
| Rate for Payer: Priority Health HMO/PPO |
$547.18
|
| Rate for Payer: Priority Health Medicare |
$158.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.39
|
| Rate for Payer: Railroad Medicare Medicare |
$157.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.47
|
| Rate for Payer: UHC Core |
$525.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.24
|
| Rate for Payer: UHC Exchange |
$157.24
|
| Rate for Payer: UHC Medicare Advantage |
$157.24
|
| Rate for Payer: VA VA |
$157.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.70
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
OP
|
$306.43
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.78 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: Aetna Medicare |
$79.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.76
|
| Rate for Payer: BCBS Complete |
$122.57
|
| Rate for Payer: BCBS MAPPO |
$76.61
|
| Rate for Payer: BCBS Trust/PPO |
$251.92
|
| Rate for Payer: BCN Commercial |
$238.25
|
| Rate for Payer: BCN Medicare Advantage |
$76.61
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.61
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: PACE Senior Care Partners |
$72.78
|
| Rate for Payer: PACE SWMI |
$76.61
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: PHP Medicare Advantage |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO |
$266.59
|
| Rate for Payer: Priority Health Medicare |
$77.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.31
|
| Rate for Payer: Railroad Medicare Medicare |
$76.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.66
|
| Rate for Payer: UHC Core |
$255.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.61
|
| Rate for Payer: UHC Exchange |
$76.61
|
| Rate for Payer: UHC Medicare Advantage |
$76.61
|
| Rate for Payer: VA VA |
$76.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC IR FLUORO GUIDE CVA
|
Facility
|
IP
|
$306.43
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
32000245
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$199.18 |
| Max. Negotiated Rate |
$275.79 |
| Rate for Payer: Aetna Commercial |
$260.47
|
| Rate for Payer: BCBS Trust/PPO |
$250.14
|
| Rate for Payer: BCN Commercial |
$236.81
|
| Rate for Payer: Cash Price |
$245.14
|
| Rate for Payer: Cofinity Commercial |
$263.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.14
|
| Rate for Payer: Healthscope Commercial |
$275.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.47
|
| Rate for Payer: Nomi Health Commercial |
$251.27
|
| Rate for Payer: PHP Commercial |
$260.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.18
|
| Rate for Payer: Priority Health HMO/PPO |
$266.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.66
|
| Rate for Payer: UHC Core |
$255.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.82
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.38 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$224.64
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCBS Trust/PPO |
$461.68
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Medicare |
$141.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Exchange |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$140.40
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC IR FLUOROSCOPIC GUIDE SPINE
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
32000247
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$365.03 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: BCBS Trust/PPO |
$458.43
|
| Rate for Payer: BCN Commercial |
$434.00
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$365.03 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: BCBS Trust/PPO |
$458.43
|
| Rate for Payer: BCN Commercial |
$434.00
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC IR FLUORO UP TO 1 HOUR DR TIME
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000231
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.38 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCBS Trust/PPO |
$461.68
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Medicare |
$141.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Exchange |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$140.40
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
