|
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 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 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 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 |
$33.55
|
| 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 |
$33.55
|
|
|
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 |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$34.79
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| 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 |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| 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 |
$11.19
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| 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 |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.19
|
| Rate for Payer: UHC Exchange |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
| Rate for Payer: VA VA |
$11.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
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 |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$121.50
|
| Rate for Payer: BCBS Trust/PPO |
$399.54
|
| Rate for Payer: BCN Commercial |
$377.87
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.58
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
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 |
$416.27
|
| 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 |
$396.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.74
|
| Rate for Payer: Meridian Medicaid |
$416.27
|
| 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 |
$396.42
|
| 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 |
$396.42
|
| Rate for Payer: VA VA |
$206.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.27
|
|
|
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 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 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 |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$489.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,609.67
|
| Rate for Payer: BCN Commercial |
$1,522.35
|
| 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 |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.98
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| 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 |
$1,481.07
|
| 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 |
$494.39
|
| 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 |
$1,481.07
|
| Rate for Payer: VA VA |
$489.50
|
| 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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,129.77
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| 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
|
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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.97
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| Rate for Payer: VA VA |
$867.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,602.77
|
|
|
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 INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
OP
|
$1,268.04
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$301.16 |
| Max. Negotiated Rate |
$1,141.24 |
| Rate for Payer: Aetna Commercial |
$1,077.83
|
| Rate for Payer: Aetna Medicare |
$329.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.26
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$317.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.46
|
| Rate for Payer: BCN Commercial |
$985.90
|
| Rate for Payer: BCN Medicare Advantage |
$317.01
|
| Rate for Payer: Cash Price |
$1,014.43
|
| 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: Health Alliance Plan Medicare Advantage |
$317.01
|
| Rate for Payer: Healthscope Commercial |
$1,141.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.03
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.86
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.83
|
| Rate for Payer: Nomi Health Commercial |
$1,039.79
|
| Rate for Payer: PACE Senior Care Partners |
$301.16
|
| Rate for Payer: PACE SWMI |
$317.01
|
| Rate for Payer: PHP Commercial |
$1,077.83
|
| Rate for Payer: PHP Medicare Advantage |
$317.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| 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 Medicare |
$320.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.59
|
| Rate for Payer: Railroad Medicare Medicare |
$317.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.88
|
| Rate for Payer: UHC Core |
$1,058.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.01
|
| Rate for Payer: UHC Exchange |
$317.01
|
| Rate for Payer: UHC Medicare Advantage |
$317.01
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$317.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.03
|
|
|
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
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
OP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$392.09 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Aetna Commercial |
$1,403.26
|
| Rate for Payer: Aetna Medicare |
$429.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$515.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$515.90
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$412.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,357.20
|
| Rate for Payer: BCN Commercial |
$1,283.57
|
| Rate for Payer: BCN Medicare Advantage |
$412.72
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.72
|
| Rate for Payer: Healthscope Commercial |
$1,485.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,238.17
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.36
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$474.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: Nomi Health Commercial |
$1,353.73
|
| Rate for Payer: PACE Senior Care Partners |
$392.09
|
| Rate for Payer: PACE SWMI |
$412.72
|
| Rate for Payer: PHP Commercial |
$1,403.26
|
| Rate for Payer: PHP Medicare Advantage |
$412.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,436.27
|
| Rate for Payer: Priority Health Medicare |
$416.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.10
|
| Rate for Payer: Railroad Medicare Medicare |
$412.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.78
|
| Rate for Payer: UHC Core |
$1,378.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$412.72
|
| Rate for Payer: UHC Exchange |
$412.72
|
| Rate for Payer: UHC Medicare Advantage |
$412.72
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$412.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,238.17
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
IP
|
$1,650.89
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,073.08 |
| Max. Negotiated Rate |
$1,485.80 |
| Rate for Payer: Aetna Commercial |
$1,403.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.62
|
| Rate for Payer: BCN Commercial |
$1,275.81
|
| Rate for Payer: Cash Price |
$1,320.71
|
| Rate for Payer: Cofinity Commercial |
$1,419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.71
|
| Rate for Payer: Healthscope Commercial |
$1,485.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,238.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.26
|
| Rate for Payer: Nomi Health Commercial |
$1,353.73
|
| Rate for Payer: PHP Commercial |
$1,403.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,436.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.78
|
| Rate for Payer: UHC Core |
$1,378.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,238.17
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,150.90 |
| Max. Negotiated Rate |
$4,361.30 |
| Rate for Payer: Aetna Commercial |
$4,119.01
|
| Rate for Payer: Aetna Medicare |
$1,259.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,514.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,514.34
|
| Rate for Payer: BCBS Complete |
$2,679.26
|
| Rate for Payer: BCBS MAPPO |
$1,211.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,983.81
|
| Rate for Payer: BCN Commercial |
$3,767.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,211.47
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$4,167.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,211.47
|
| Rate for Payer: Healthscope Commercial |
$4,361.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,634.42
|
| Rate for Payer: Mclaren Medicaid |
$2,551.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,272.05
|
| Rate for Payer: Meridian Medicaid |
$2,679.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,393.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| Rate for Payer: PACE Senior Care Partners |
$1,150.90
|
| Rate for Payer: PACE SWMI |
$1,211.47
|
| Rate for Payer: PHP Commercial |
$4,119.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,211.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,551.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: Priority Health HMO/PPO |
$4,215.92
|
| Rate for Payer: Priority Health Medicare |
$1,223.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,246.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,211.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.38
|
| Rate for Payer: UHC Core |
$4,046.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,211.47
|
| Rate for Payer: UHC Exchange |
$1,211.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,211.47
|
| Rate for Payer: UHCCP Medicaid |
$2,551.51
|
| Rate for Payer: VA VA |
$1,211.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,634.42
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,845.89
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,149.83 |
| Max. Negotiated Rate |
$4,361.30 |
| Rate for Payer: Aetna Commercial |
$4,119.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,955.70
|
| Rate for Payer: BCN Commercial |
$3,744.90
|
| Rate for Payer: Cash Price |
$3,876.71
|
| Rate for Payer: Cofinity Commercial |
$4,167.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,876.71
|
| Rate for Payer: Healthscope Commercial |
$4,361.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,634.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,119.01
|
| Rate for Payer: Nomi Health Commercial |
$3,973.63
|
| Rate for Payer: PHP Commercial |
$4,119.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.83
|
| Rate for Payer: Priority Health HMO/PPO |
$4,215.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,246.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.38
|
| Rate for Payer: UHC Core |
$4,046.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,634.42
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,154.46 |
| Max. Negotiated Rate |
$4,374.79 |
| Rate for Payer: Aetna Commercial |
$4,131.75
|
| Rate for Payer: Aetna Medicare |
$1,263.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,519.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,519.03
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$1,215.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,996.13
|
| Rate for Payer: BCN Commercial |
$3,779.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,215.22
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,180.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,215.22
|
| Rate for Payer: Healthscope Commercial |
$4,374.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,645.66
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,275.98
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,397.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| Rate for Payer: PACE Senior Care Partners |
$1,154.46
|
| Rate for Payer: PACE SWMI |
$1,215.22
|
| Rate for Payer: PHP Commercial |
$4,131.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,215.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: Priority Health HMO/PPO |
$4,228.97
|
| Rate for Payer: Priority Health Medicare |
$1,227.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,256.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,215.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,277.57
|
| Rate for Payer: UHC Core |
$4,058.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,215.22
|
| Rate for Payer: UHC Exchange |
$1,215.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,215.22
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$1,215.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,645.66
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,860.88
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,159.57 |
| Max. Negotiated Rate |
$4,374.79 |
| Rate for Payer: Aetna Commercial |
$4,131.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,967.94
|
| Rate for Payer: BCN Commercial |
$3,756.49
|
| Rate for Payer: Cash Price |
$3,888.70
|
| Rate for Payer: Cofinity Commercial |
$4,180.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,888.70
|
| Rate for Payer: Healthscope Commercial |
$4,374.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,645.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,131.75
|
| Rate for Payer: Nomi Health Commercial |
$3,985.92
|
| Rate for Payer: PHP Commercial |
$4,131.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,159.57
|
| Rate for Payer: Priority Health HMO/PPO |
$4,228.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,256.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,277.57
|
| Rate for Payer: UHC Core |
$4,058.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,645.66
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,086.28 |
| Max. Negotiated Rate |
$4,116.44 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: Aetna Medicare |
$1,189.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,429.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,429.32
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$1,143.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,760.14
|
| Rate for Payer: BCN Commercial |
$3,556.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,143.45
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,143.45
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,430.36
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,200.63
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,314.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,086.28
|
| Rate for Payer: PACE SWMI |
$1,143.45
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,143.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,979.22
|
| Rate for Payer: Priority Health Medicare |
$1,154.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,064.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,143.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,024.96
|
| Rate for Payer: UHC Core |
$3,819.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,143.45
|
| Rate for Payer: UHC Exchange |
$1,143.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,143.45
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$1,143.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,430.36
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,573.82
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,972.98 |
| Max. Negotiated Rate |
$4,116.44 |
| Rate for Payer: Aetna Commercial |
$3,887.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,733.61
|
| Rate for Payer: BCN Commercial |
$3,534.65
|
| Rate for Payer: Cash Price |
$3,659.06
|
| Rate for Payer: Cofinity Commercial |
$3,933.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,659.06
|
| Rate for Payer: Healthscope Commercial |
$4,116.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,430.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,887.75
|
| Rate for Payer: Nomi Health Commercial |
$3,750.53
|
| Rate for Payer: PHP Commercial |
$3,887.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,972.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,979.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,064.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,024.96
|
| Rate for Payer: UHC Core |
$3,819.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,430.36
|
|
