|
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 |
$1,918.61
|
| 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 |
$1,918.61
|
|
|
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 |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$639.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.05
|
| Rate for Payer: BCN Commercial |
$1,988.95
|
| Rate for Payer: BCN Medicare Advantage |
$639.53
|
| 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 |
$639.53
|
| Rate for Payer: Healthscope Commercial |
$2,302.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,918.61
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.51
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| 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 |
$639.53
|
| Rate for Payer: PHP Commercial |
$2,174.42
|
| Rate for Payer: PHP Medicare Advantage |
$639.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| 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 |
$639.53
|
| 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 |
$639.53
|
| Rate for Payer: UHC Exchange |
$639.53
|
| Rate for Payer: UHC Medicare Advantage |
$639.53
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$639.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,918.61
|
|
|
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 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 |
$1,482.54
|
| 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 |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$768.87
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| 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 |
$1,411.85
|
| 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 |
$1,411.85
|
| Rate for Payer: VA VA |
$732.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,196.77
|
|
|
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 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 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 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 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 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 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
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 |
$731.53
|
| 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 |
$731.53
|
|
|
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 |
$525.76
|
| 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 |
$731.53
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.04
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| 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 |
$500.69
|
| 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 |
$500.69
|
| Rate for Payer: VA VA |
$243.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.53
|
|
|
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 |
$1,280.87
|
| 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 |
$376.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.82
|
| Rate for Payer: BCN Commercial |
$1,171.61
|
| Rate for Payer: BCN Medicare Advantage |
$376.73
|
| 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 |
$376.73
|
| Rate for Payer: Healthscope Commercial |
$1,356.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.17
|
| 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 |
$1,280.87
|
| Rate for Payer: Nomi Health Commercial |
$1,235.66
|
| Rate for Payer: PACE Senior Care Partners |
$357.89
|
| Rate for Payer: PACE SWMI |
$376.73
|
| Rate for Payer: PHP Commercial |
$1,280.87
|
| Rate for Payer: PHP Medicare Advantage |
$376.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.49
|
| 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 |
$376.73
|
| 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 |
$376.73
|
| Rate for Payer: UHC Exchange |
$376.73
|
| Rate for Payer: UHC Medicare Advantage |
$376.73
|
| Rate for Payer: VA VA |
$376.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.17
|
|
|
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 |
$979.49 |
| Max. Negotiated Rate |
$1,356.21 |
| Rate for Payer: Aetna Commercial |
$1,280.87
|
| 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 |
$1,130.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.87
|
| Rate for Payer: Nomi Health Commercial |
$1,235.66
|
| Rate for Payer: PHP Commercial |
$1,280.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.49
|
| 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 |
$1,130.17
|
|
|
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 |
$711.80
|
| 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 |
$677.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.97
|
| Rate for Payer: Meridian Medicaid |
$711.80
|
| 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 |
$677.86
|
| 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 |
$677.86
|
| 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
|
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 |
$255.25
|
| 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 |
$255.25
|
|
|
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 |
$255.25
|
| 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 |
$255.25
|
|
|
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
|
|
