|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$975.38
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$231.65 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna Medicare |
$253.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$304.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$304.81
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$243.84
|
| Rate for Payer: BCBS Trust/PPO |
$801.86
|
| Rate for Payer: BCN Commercial |
$758.36
|
| Rate for Payer: BCN Medicare Advantage |
$243.84
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.84
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.54
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.04
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: Nomi Health Commercial |
$799.81
|
| Rate for Payer: PACE Senior Care Partners |
$231.65
|
| Rate for Payer: PACE SWMI |
$243.84
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$243.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health HMO/PPO |
$848.58
|
| Rate for Payer: Priority Health Medicare |
$246.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.50
|
| Rate for Payer: Railroad Medicare Medicare |
$243.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.33
|
| Rate for Payer: UHC Core |
$814.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.84
|
| Rate for Payer: UHC Exchange |
$243.84
|
| Rate for Payer: UHC Medicare Advantage |
$243.84
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$243.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.54
|
|
|
HC IR GENICULAR NERVE BRANCHES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$975.38
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36100581
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$634.00 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$796.20
|
| Rate for Payer: BCN Commercial |
$753.77
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: Nomi Health Commercial |
$799.81
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health HMO/PPO |
$848.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.33
|
| Rate for Payer: UHC Core |
$814.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.54
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
IP
|
$1,506.90
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$979.48 |
| Max. Negotiated Rate |
$1,356.21 |
| Rate for Payer: Aetna Commercial |
$1,280.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.08
|
| Rate for Payer: BCN Commercial |
$1,164.53
|
| Rate for Payer: Cash Price |
$1,205.52
|
| Rate for Payer: Cofinity Commercial |
$1,295.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.52
|
| Rate for Payer: Healthscope Commercial |
$1,356.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.86
|
| Rate for Payer: Nomi Health Commercial |
$1,235.66
|
| Rate for Payer: PHP Commercial |
$1,280.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,311.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,326.07
|
| Rate for Payer: UHC Core |
$1,258.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.18
|
|
|
HC IR GI BILI DUCT DIL W WO STENT
|
Facility
|
OP
|
$1,506.90
|
|
|
Service Code
|
CPT 74363
|
| Hospital Charge Code |
32000157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$357.89 |
| Max. Negotiated Rate |
$1,356.21 |
| Rate for Payer: Aetna Commercial |
$1,280.86
|
| Rate for Payer: Aetna Medicare |
$391.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$470.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$470.91
|
| Rate for Payer: BCBS Complete |
$602.76
|
| Rate for Payer: BCBS MAPPO |
$376.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.82
|
| Rate for Payer: BCN Commercial |
$1,171.61
|
| Rate for Payer: BCN Medicare Advantage |
$376.72
|
| Rate for Payer: Cash Price |
$1,205.52
|
| Rate for Payer: Cofinity Commercial |
$1,295.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.72
|
| Rate for Payer: Healthscope Commercial |
$1,356.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$433.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.86
|
| Rate for Payer: Nomi Health Commercial |
$1,235.66
|
| Rate for Payer: PACE Senior Care Partners |
$357.89
|
| Rate for Payer: PACE SWMI |
$376.72
|
| Rate for Payer: PHP Commercial |
$1,280.86
|
| Rate for Payer: PHP Medicare Advantage |
$376.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.48
|
| Rate for Payer: Priority Health HMO/PPO |
$1,311.00
|
| Rate for Payer: Priority Health Medicare |
$380.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.62
|
| Rate for Payer: Railroad Medicare Medicare |
$376.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,326.07
|
| Rate for Payer: UHC Core |
$1,258.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.72
|
| Rate for Payer: UHC Exchange |
$376.72
|
| Rate for Payer: UHC Medicare Advantage |
$376.72
|
| Rate for Payer: VA VA |
$376.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.18
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
IP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,433.63 |
| Max. Negotiated Rate |
$1,985.03 |
| Rate for Payer: Aetna Commercial |
$1,874.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,800.42
|
| Rate for Payer: BCN Commercial |
$1,704.48
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$1,896.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Healthscope Commercial |
$1,985.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: Nomi Health Commercial |
$1,808.58
|
| Rate for Payer: PHP Commercial |
$1,874.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,918.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,477.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,940.92
|
| Rate for Payer: UHC Core |
$1,841.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.19
|
|
|
HC IR GI INJ PREV PLACE GI TUBE FL
|
Facility
|
OP
|
$2,205.59
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100194
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.83 |
| Max. Negotiated Rate |
$1,985.03 |
| Rate for Payer: Aetna Commercial |
$1,874.75
|
| Rate for Payer: Aetna Medicare |
$573.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$689.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$689.25
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$551.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.22
|
| Rate for Payer: BCN Commercial |
$1,714.85
|
| Rate for Payer: BCN Medicare Advantage |
$551.40
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cash Price |
$1,764.47
|
| Rate for Payer: Cofinity Commercial |
$1,896.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,764.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.40
|
| Rate for Payer: Healthscope Commercial |
$1,985.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,654.19
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.97
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,874.75
|
| Rate for Payer: Nomi Health Commercial |
$1,808.58
|
| Rate for Payer: PACE Senior Care Partners |
$523.83
|
| Rate for Payer: PACE SWMI |
$551.40
|
| Rate for Payer: PHP Commercial |
$1,874.75
|
| Rate for Payer: PHP Medicare Advantage |
$551.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,433.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,918.86
|
| Rate for Payer: Priority Health Medicare |
$556.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,477.75
|
| Rate for Payer: Railroad Medicare Medicare |
$551.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,940.92
|
| Rate for Payer: UHC Core |
$1,841.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.40
|
| Rate for Payer: UHC Exchange |
$551.40
|
| Rate for Payer: UHC Medicare Advantage |
$551.40
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$551.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,654.19
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$80.83 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$88.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.36
|
| Rate for Payer: BCBS Complete |
$136.14
|
| Rate for Payer: BCBS MAPPO |
$85.08
|
| Rate for Payer: BCBS Trust/PPO |
$279.79
|
| Rate for Payer: BCN Commercial |
$264.61
|
| Rate for Payer: BCN Medicare Advantage |
$85.08
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.08
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PACE Senior Care Partners |
$80.83
|
| Rate for Payer: PACE SWMI |
$85.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Medicare |
$85.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.08
|
| Rate for Payer: UHC Exchange |
$85.08
|
| Rate for Payer: UHC Medicare Advantage |
$85.08
|
| Rate for Payer: VA VA |
$85.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.26
|
|
|
HC IR GI LONG TUBE PLACEMENT GUIDANCE
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 74340
|
| Hospital Charge Code |
32000156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: BCBS Trust/PPO |
$277.82
|
| Rate for Payer: BCN Commercial |
$263.01
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.26
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
IP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$169.87 |
| Max. Negotiated Rate |
$235.21 |
| Rate for Payer: Aetna Commercial |
$222.14
|
| Rate for Payer: BCBS Trust/PPO |
$213.33
|
| Rate for Payer: BCN Commercial |
$201.96
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$224.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Healthscope Commercial |
$235.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: Nomi Health Commercial |
$214.30
|
| Rate for Payer: PHP Commercial |
$222.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: Priority Health HMO/PPO |
$227.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.98
|
| Rate for Payer: UHC Core |
$218.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.00
|
|
|
HC IR GUIDE FNA DIAGNOSTIC ASPIRA
|
Facility
|
OP
|
$261.34
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200057
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.83 |
| Max. Negotiated Rate |
$235.21 |
| Rate for Payer: Aetna Commercial |
$222.14
|
| Rate for Payer: Aetna Medicare |
$67.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.67
|
| Rate for Payer: BCBS Complete |
$104.54
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCBS Trust/PPO |
$214.85
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$203.19
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cash Price |
$209.07
|
| Rate for Payer: Cofinity Commercial |
$224.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$235.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.14
|
| Rate for Payer: Nomi Health Commercial |
$214.30
|
| Rate for Payer: PACE Senior Care Partners |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$222.14
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.87
|
| Rate for Payer: Priority Health HMO/PPO |
$227.37
|
| Rate for Payer: Priority Health Medicare |
$65.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.10
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.98
|
| Rate for Payer: UHC Core |
$218.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$65.34
|
| Rate for Payer: UHC Medicare Advantage |
$65.34
|
| Rate for Payer: VA VA |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.00
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$349.84 |
| 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 |
$155.48
|
| 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: 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| 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 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: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC IR GUIDE VISCERAL TISSUE AB
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
32000244
|
|
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 GUIDEWIRE
|
Facility
|
IP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
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 GUIDEWIRE
|
Facility
|
OP
|
$44.74
|
|
| Hospital Charge Code |
27200306
|
|
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 GU NEPHROSTOGRAM BILAT
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$315.90 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: BCBS Trust/PPO |
$396.72
|
| Rate for Payer: BCN Commercial |
$375.58
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO |
$422.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.68
|
| Rate for Payer: UHC Core |
$405.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC IR GU NEPHROSTOGRAM BILAT
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000162
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$115.42 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$126.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.88
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$121.50
|
| Rate for Payer: BCBS Trust/PPO |
$399.54
|
| Rate for Payer: BCN Commercial |
$377.86
|
| Rate for Payer: BCN Medicare Advantage |
$121.50
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.50
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.58
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: PACE Senior Care Partners |
$115.42
|
| Rate for Payer: PACE SWMI |
$121.50
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$121.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO |
$422.82
|
| Rate for Payer: Priority Health Medicare |
$122.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.62
|
| Rate for Payer: Railroad Medicare Medicare |
$121.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.68
|
| Rate for Payer: UHC Core |
$405.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.50
|
| Rate for Payer: UHC Exchange |
$121.50
|
| Rate for Payer: UHC Medicare Advantage |
$121.50
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$121.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
IP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$536.70 |
| Max. Negotiated Rate |
$743.12 |
| Rate for Payer: Aetna Commercial |
$701.84
|
| Rate for Payer: BCBS Trust/PPO |
$674.01
|
| Rate for Payer: BCN Commercial |
$638.09
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$710.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Healthscope Commercial |
$743.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$677.07
|
| Rate for Payer: PHP Commercial |
$701.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health HMO/PPO |
$718.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$553.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.61
|
| Rate for Payer: UHC Core |
$689.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.27
|
|
|
HC IR GU RENAL CYST STUDY
|
Facility
|
OP
|
$825.69
|
|
|
Service Code
|
CPT 74470
|
| Hospital Charge Code |
32000167
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$196.10 |
| Max. Negotiated Rate |
$743.12 |
| Rate for Payer: Aetna Commercial |
$701.84
|
| Rate for Payer: Aetna Medicare |
$214.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.03
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$206.42
|
| Rate for Payer: BCBS Trust/PPO |
$678.80
|
| Rate for Payer: BCN Commercial |
$641.97
|
| Rate for Payer: BCN Medicare Advantage |
$206.42
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cash Price |
$660.55
|
| Rate for Payer: Cofinity Commercial |
$710.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$743.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.27
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.74
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.84
|
| Rate for Payer: Nomi Health Commercial |
$677.07
|
| Rate for Payer: PACE Senior Care Partners |
$196.10
|
| Rate for Payer: PACE SWMI |
$206.42
|
| Rate for Payer: PHP Commercial |
$701.84
|
| Rate for Payer: PHP Medicare Advantage |
$206.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.70
|
| Rate for Payer: Priority Health HMO/PPO |
$718.35
|
| Rate for Payer: Priority Health Medicare |
$208.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$553.21
|
| Rate for Payer: Railroad Medicare Medicare |
$206.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.61
|
| Rate for Payer: UHC Core |
$689.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.42
|
| Rate for Payer: UHC Exchange |
$206.42
|
| Rate for Payer: UHC Medicare Advantage |
$206.42
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$206.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.27
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
OP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$465.02 |
| Max. Negotiated Rate |
$1,762.20 |
| Rate for Payer: Aetna Commercial |
$1,664.30
|
| Rate for Payer: Aetna Medicare |
$509.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.88
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$489.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,609.67
|
| Rate for Payer: BCN Commercial |
$1,522.34
|
| Rate for Payer: BCN Medicare Advantage |
$489.50
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,683.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.50
|
| Rate for Payer: Healthscope Commercial |
$1,762.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.50
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.98
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: Nomi Health Commercial |
$1,605.56
|
| Rate for Payer: PACE Senior Care Partners |
$465.02
|
| Rate for Payer: PACE SWMI |
$489.50
|
| Rate for Payer: PHP Commercial |
$1,664.30
|
| Rate for Payer: PHP Medicare Advantage |
$489.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,703.46
|
| Rate for Payer: Priority Health Medicare |
$494.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,311.86
|
| Rate for Payer: Railroad Medicare Medicare |
$489.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.04
|
| Rate for Payer: UHC Core |
$1,634.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.50
|
| Rate for Payer: UHC Exchange |
$489.50
|
| Rate for Payer: UHC Medicare Advantage |
$489.50
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$489.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.50
|
|
|
HC IR GU URETERAL DILATATION
|
Facility
|
IP
|
$1,958.00
|
|
|
Service Code
|
CPT 74485
|
| Hospital Charge Code |
32000173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,272.70 |
| Max. Negotiated Rate |
$1,762.20 |
| Rate for Payer: Aetna Commercial |
$1,664.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.32
|
| Rate for Payer: BCN Commercial |
$1,513.14
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$1,683.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.40
|
| Rate for Payer: Healthscope Commercial |
$1,762.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,664.30
|
| Rate for Payer: Nomi Health Commercial |
$1,605.56
|
| Rate for Payer: PHP Commercial |
$1,664.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,272.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,703.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,311.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.04
|
| Rate for Payer: UHC Core |
$1,634.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.50
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,022.17 |
| Max. Negotiated Rate |
$3,873.50 |
| Rate for Payer: Aetna Commercial |
$3,658.31
|
| Rate for Payer: Aetna Medicare |
$1,119.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,344.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,344.97
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,075.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,538.23
|
| Rate for Payer: BCN Commercial |
$3,346.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,075.97
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$3,701.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,075.97
|
| Rate for Payer: Healthscope Commercial |
$3,873.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,227.92
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,129.77
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,237.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$3,529.19
|
| Rate for Payer: PACE Senior Care Partners |
$1,022.17
|
| Rate for Payer: PACE SWMI |
$1,075.97
|
| Rate for Payer: PHP Commercial |
$3,658.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,075.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,744.38
|
| Rate for Payer: Priority Health Medicare |
$1,086.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,883.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,075.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,787.42
|
| Rate for Payer: UHC Core |
$3,593.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,075.97
|
| Rate for Payer: UHC Exchange |
$1,075.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,075.97
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,075.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,227.92
|
|
|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
IP
|
$4,303.89
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,797.53 |
| Max. Negotiated Rate |
$3,873.50 |
| Rate for Payer: Aetna Commercial |
$3,658.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,513.27
|
| Rate for Payer: BCN Commercial |
$3,326.05
|
| Rate for Payer: Cash Price |
$3,443.11
|
| Rate for Payer: Cofinity Commercial |
$3,701.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,443.11
|
| Rate for Payer: Healthscope Commercial |
$3,873.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,227.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,658.31
|
| Rate for Payer: Nomi Health Commercial |
$3,529.19
|
| Rate for Payer: PHP Commercial |
$3,658.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,744.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,883.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,787.42
|
| Rate for Payer: UHC Core |
$3,593.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,227.92
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
IP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,255.73 |
| Max. Negotiated Rate |
$3,123.32 |
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,832.85
|
| Rate for Payer: BCN Commercial |
$2,681.89
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,602.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$2,845.70
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health HMO/PPO |
$3,019.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,325.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,053.92
|
| Rate for Payer: UHC Core |
$2,897.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,602.77
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,470.36
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$824.21 |
| Max. Negotiated Rate |
$3,123.32 |
| Rate for Payer: Aetna Commercial |
$2,949.81
|
| Rate for Payer: Aetna Medicare |
$902.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,084.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,084.49
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$867.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,852.98
|
| Rate for Payer: BCN Commercial |
$2,698.20
|
| Rate for Payer: BCN Medicare Advantage |
$867.59
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cash Price |
$2,776.29
|
| Rate for Payer: Cofinity Commercial |
$2,984.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,776.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$867.59
|
| Rate for Payer: Healthscope Commercial |
$3,123.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,602.77
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.97
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$997.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,949.81
|
| Rate for Payer: Nomi Health Commercial |
$2,845.70
|
| Rate for Payer: PACE Senior Care Partners |
$824.21
|
| Rate for Payer: PACE SWMI |
$867.59
|
| Rate for Payer: PHP Commercial |
$2,949.81
|
| Rate for Payer: PHP Medicare Advantage |
$867.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,255.73
|
| Rate for Payer: Priority Health HMO/PPO |
$3,019.21
|
| Rate for Payer: Priority Health Medicare |
$876.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,325.14
|
| Rate for Payer: Railroad Medicare Medicare |
$867.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,053.92
|
| Rate for Payer: UHC Core |
$2,897.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$867.59
|
| Rate for Payer: UHC Exchange |
$867.59
|
| Rate for Payer: UHC Medicare Advantage |
$867.59
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$867.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,602.77
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
IP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$824.23 |
| Max. Negotiated Rate |
$1,141.24 |
| Rate for Payer: Aetna Commercial |
$1,077.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.10
|
| Rate for Payer: BCN Commercial |
$979.94
|
| Rate for Payer: Cash Price |
$1,014.43
|
| Rate for Payer: Cofinity Commercial |
$1,090.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.43
|
| Rate for Payer: Healthscope Commercial |
$1,141.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: Nomi Health Commercial |
$1,039.79
|
| Rate for Payer: PHP Commercial |
$1,077.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,103.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.88
|
| Rate for Payer: UHC Core |
$1,058.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.03
|
|
