|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,155.66 |
| Max. Negotiated Rate |
$4,379.33 |
| Rate for Payer: Aetna Commercial |
$4,136.03
|
| Rate for Payer: Aetna Medicare |
$1,265.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,520.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,520.60
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$1,216.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,000.27
|
| Rate for Payer: BCN Commercial |
$3,783.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,216.48
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,184.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,216.48
|
| Rate for Payer: Healthscope Commercial |
$4,379.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.44
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,277.30
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,398.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,155.66
|
| Rate for Payer: PACE SWMI |
$1,216.48
|
| Rate for Payer: PHP Commercial |
$4,136.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,216.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: Priority Health HMO/PPO |
$4,233.35
|
| Rate for Payer: Priority Health Medicare |
$1,228.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,260.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,216.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,282.01
|
| Rate for Payer: UHC Core |
$4,063.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,216.48
|
| Rate for Payer: UHC Exchange |
$1,216.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,216.48
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$1,216.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.44
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,865.92
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,162.85 |
| Max. Negotiated Rate |
$4,379.33 |
| Rate for Payer: Aetna Commercial |
$4,136.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,972.05
|
| Rate for Payer: BCN Commercial |
$3,760.38
|
| Rate for Payer: Cash Price |
$3,892.74
|
| Rate for Payer: Cofinity Commercial |
$4,184.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,892.74
|
| Rate for Payer: Healthscope Commercial |
$4,379.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.03
|
| Rate for Payer: Nomi Health Commercial |
$3,990.05
|
| Rate for Payer: PHP Commercial |
$4,136.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,162.85
|
| Rate for Payer: Priority Health HMO/PPO |
$4,233.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,260.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,282.01
|
| Rate for Payer: UHC Core |
$4,063.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.44
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,284.22 |
| Max. Negotiated Rate |
$1,778.15 |
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.78
|
| Rate for Payer: BCN Commercial |
$1,526.84
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: PHP Commercial |
$1,679.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,718.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,323.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.63
|
| Rate for Payer: UHC Core |
$1,649.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,975.72
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$469.23 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$1,679.36
|
| Rate for Payer: Aetna Medicare |
$513.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$617.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$617.41
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$493.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,624.24
|
| Rate for Payer: BCN Commercial |
$1,536.12
|
| Rate for Payer: BCN Medicare Advantage |
$493.93
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cash Price |
$1,580.58
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.93
|
| Rate for Payer: Healthscope Commercial |
$1,778.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.79
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$518.63
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$568.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,679.36
|
| Rate for Payer: Nomi Health Commercial |
$1,620.09
|
| Rate for Payer: PACE Senior Care Partners |
$469.23
|
| Rate for Payer: PACE SWMI |
$493.93
|
| Rate for Payer: PHP Commercial |
$1,679.36
|
| Rate for Payer: PHP Medicare Advantage |
$493.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,284.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,718.88
|
| Rate for Payer: Priority Health Medicare |
$498.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,323.73
|
| Rate for Payer: Railroad Medicare Medicare |
$493.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.63
|
| Rate for Payer: UHC Core |
$1,649.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.93
|
| Rate for Payer: UHC Exchange |
$493.93
|
| Rate for Payer: UHC Medicare Advantage |
$493.93
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$493.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.79
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,681.82 |
| Max. Negotiated Rate |
$2,328.67 |
| Rate for Payer: Aetna Commercial |
$2,199.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,112.10
|
| Rate for Payer: BCN Commercial |
$1,999.55
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,225.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Healthscope Commercial |
$2,328.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,940.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: PHP Commercial |
$2,199.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: Priority Health HMO/PPO |
$2,251.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,276.92
|
| Rate for Payer: UHC Core |
$2,160.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,940.56
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,587.41
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$2,199.30
|
| Rate for Payer: Aetna Medicare |
$672.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$808.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$808.57
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$646.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,127.11
|
| Rate for Payer: BCN Commercial |
$2,011.71
|
| Rate for Payer: BCN Medicare Advantage |
$646.85
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cash Price |
$2,069.93
|
| Rate for Payer: Cofinity Commercial |
$2,225.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.85
|
| Rate for Payer: Healthscope Commercial |
$2,328.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,940.56
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.20
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$743.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,199.30
|
| Rate for Payer: Nomi Health Commercial |
$2,121.68
|
| Rate for Payer: PACE Senior Care Partners |
$614.51
|
| Rate for Payer: PACE SWMI |
$646.85
|
| Rate for Payer: PHP Commercial |
$2,199.30
|
| Rate for Payer: PHP Medicare Advantage |
$646.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.82
|
| Rate for Payer: Priority Health HMO/PPO |
$2,251.05
|
| Rate for Payer: Priority Health Medicare |
$653.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.56
|
| Rate for Payer: Railroad Medicare Medicare |
$646.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,276.92
|
| Rate for Payer: UHC Core |
$2,160.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$646.85
|
| Rate for Payer: UHC Exchange |
$646.85
|
| Rate for Payer: UHC Medicare Advantage |
$646.85
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$646.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,940.56
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.80 |
| Max. Negotiated Rate |
$1,253.55 |
| Rate for Payer: Aetna Commercial |
$1,183.91
|
| Rate for Payer: Aetna Medicare |
$362.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.26
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$348.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,145.05
|
| Rate for Payer: BCN Commercial |
$1,082.93
|
| Rate for Payer: BCN Medicare Advantage |
$348.21
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,197.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.21
|
| Rate for Payer: Healthscope Commercial |
$1,253.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.62
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.62
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: PACE Senior Care Partners |
$330.80
|
| Rate for Payer: PACE SWMI |
$348.21
|
| Rate for Payer: PHP Commercial |
$1,183.91
|
| Rate for Payer: PHP Medicare Advantage |
$348.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,211.76
|
| Rate for Payer: Priority Health Medicare |
$351.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.20
|
| Rate for Payer: Railroad Medicare Medicare |
$348.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.69
|
| Rate for Payer: UHC Core |
$1,163.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.21
|
| Rate for Payer: UHC Exchange |
$348.21
|
| Rate for Payer: UHC Medicare Advantage |
$348.21
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$348.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.62
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,392.83
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$905.34 |
| Max. Negotiated Rate |
$1,253.55 |
| Rate for Payer: Aetna Commercial |
$1,183.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.97
|
| Rate for Payer: BCN Commercial |
$1,076.38
|
| Rate for Payer: Cash Price |
$1,114.26
|
| Rate for Payer: Cofinity Commercial |
$1,197.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,114.26
|
| Rate for Payer: Healthscope Commercial |
$1,253.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,183.91
|
| Rate for Payer: Nomi Health Commercial |
$1,142.12
|
| Rate for Payer: PHP Commercial |
$1,183.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$905.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,211.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.69
|
| Rate for Payer: UHC Core |
$1,163.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.62
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.37 |
| Max. Negotiated Rate |
$956.37 |
| Rate for Payer: Aetna Commercial |
$903.24
|
| Rate for Payer: Aetna Medicare |
$276.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.07
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$265.66
|
| Rate for Payer: BCBS Trust/PPO |
$873.59
|
| Rate for Payer: BCN Commercial |
$826.19
|
| Rate for Payer: BCN Medicare Advantage |
$265.66
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$913.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.66
|
| Rate for Payer: Healthscope Commercial |
$956.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.97
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.94
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: PACE Senior Care Partners |
$252.37
|
| Rate for Payer: PACE SWMI |
$265.66
|
| Rate for Payer: PHP Commercial |
$903.24
|
| Rate for Payer: PHP Medicare Advantage |
$265.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health HMO/PPO |
$924.49
|
| Rate for Payer: Priority Health Medicare |
$268.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$711.96
|
| Rate for Payer: Railroad Medicare Medicare |
$265.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.11
|
| Rate for Payer: UHC Core |
$887.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.66
|
| Rate for Payer: UHC Exchange |
$265.66
|
| Rate for Payer: UHC Medicare Advantage |
$265.66
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$265.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.97
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,062.63
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$690.71 |
| Max. Negotiated Rate |
$956.37 |
| Rate for Payer: Aetna Commercial |
$903.24
|
| Rate for Payer: BCBS Trust/PPO |
$867.42
|
| Rate for Payer: BCN Commercial |
$821.20
|
| Rate for Payer: Cash Price |
$850.10
|
| Rate for Payer: Cofinity Commercial |
$913.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.10
|
| Rate for Payer: Healthscope Commercial |
$956.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$903.24
|
| Rate for Payer: Nomi Health Commercial |
$871.36
|
| Rate for Payer: PHP Commercial |
$903.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$690.71
|
| Rate for Payer: Priority Health HMO/PPO |
$924.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$711.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.11
|
| Rate for Payer: UHC Core |
$887.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.97
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,968.32 |
| Max. Negotiated Rate |
$2,725.37 |
| Rate for Payer: Aetna Commercial |
$2,573.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,471.91
|
| Rate for Payer: BCN Commercial |
$2,340.19
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,604.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Healthscope Commercial |
$2,725.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,271.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: PHP Commercial |
$2,573.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,634.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,028.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,664.81
|
| Rate for Payer: UHC Core |
$2,528.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,271.14
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,028.19
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$719.20 |
| Max. Negotiated Rate |
$2,725.37 |
| Rate for Payer: Aetna Commercial |
$2,573.96
|
| Rate for Payer: Aetna Medicare |
$787.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$946.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$946.31
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$757.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.47
|
| Rate for Payer: BCN Commercial |
$2,354.42
|
| Rate for Payer: BCN Medicare Advantage |
$757.05
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cash Price |
$2,422.55
|
| Rate for Payer: Cofinity Commercial |
$2,604.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,422.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.05
|
| Rate for Payer: Healthscope Commercial |
$2,725.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,271.14
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$794.90
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$870.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,573.96
|
| Rate for Payer: Nomi Health Commercial |
$2,483.12
|
| Rate for Payer: PACE Senior Care Partners |
$719.20
|
| Rate for Payer: PACE SWMI |
$757.05
|
| Rate for Payer: PHP Commercial |
$2,573.96
|
| Rate for Payer: PHP Medicare Advantage |
$757.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,968.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,634.53
|
| Rate for Payer: Priority Health Medicare |
$764.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,028.89
|
| Rate for Payer: Railroad Medicare Medicare |
$757.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,664.81
|
| Rate for Payer: UHC Core |
$2,528.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$757.05
|
| Rate for Payer: UHC Exchange |
$757.05
|
| Rate for Payer: UHC Medicare Advantage |
$757.05
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$757.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,271.14
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$308.65 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$1,104.66
|
| Rate for Payer: Aetna Medicare |
$337.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.12
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$324.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.40
|
| Rate for Payer: BCN Commercial |
$1,010.44
|
| Rate for Payer: BCN Medicare Advantage |
$324.90
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,117.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.90
|
| Rate for Payer: Healthscope Commercial |
$1,169.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.70
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.14
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: PACE Senior Care Partners |
$308.65
|
| Rate for Payer: PACE SWMI |
$324.90
|
| Rate for Payer: PHP Commercial |
$1,104.66
|
| Rate for Payer: PHP Medicare Advantage |
$324.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,130.65
|
| Rate for Payer: Priority Health Medicare |
$328.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.73
|
| Rate for Payer: Railroad Medicare Medicare |
$324.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,143.65
|
| Rate for Payer: UHC Core |
$1,085.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.90
|
| Rate for Payer: UHC Exchange |
$324.90
|
| Rate for Payer: UHC Medicare Advantage |
$324.90
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$324.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.70
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,299.60
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$844.74 |
| Max. Negotiated Rate |
$1,169.64 |
| Rate for Payer: Aetna Commercial |
$1,104.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.86
|
| Rate for Payer: BCN Commercial |
$1,004.33
|
| Rate for Payer: Cash Price |
$1,039.68
|
| Rate for Payer: Cofinity Commercial |
$1,117.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.68
|
| Rate for Payer: Healthscope Commercial |
$1,169.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,104.66
|
| Rate for Payer: Nomi Health Commercial |
$1,065.67
|
| Rate for Payer: PHP Commercial |
$1,104.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,130.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$870.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,143.65
|
| Rate for Payer: UHC Core |
$1,085.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.70
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$450.76
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$151.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.28
|
| Rate for Payer: BCBS Complete |
$331.91
|
| Rate for Payer: BCBS MAPPO |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$479.51
|
| Rate for Payer: BCN Commercial |
$453.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.82
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.82
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$316.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$331.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Senior Care Partners |
$138.53
|
| Rate for Payer: PACE SWMI |
$145.82
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Medicare |
$147.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: Railroad Medicare Medicare |
$145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.82
|
| Rate for Payer: UHC Exchange |
$145.82
|
| Rate for Payer: UHC Medicare Advantage |
$145.82
|
| Rate for Payer: UHCCP Medicaid |
$316.08
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$872.68 |
| Max. Negotiated Rate |
$4,104.01 |
| Rate for Payer: Aetna Commercial |
$3,123.29
|
| Rate for Payer: Aetna Medicare |
$955.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.27
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$918.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.77
|
| Rate for Payer: BCN Commercial |
$2,856.89
|
| Rate for Payer: BCN Medicare Advantage |
$918.62
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,160.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.62
|
| Rate for Payer: Healthscope Commercial |
$3,307.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.84
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.55
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: PACE Senior Care Partners |
$872.68
|
| Rate for Payer: PACE SWMI |
$918.62
|
| Rate for Payer: PHP Commercial |
$3,123.29
|
| Rate for Payer: PHP Medicare Advantage |
$918.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health HMO/PPO |
$3,196.78
|
| Rate for Payer: Priority Health Medicare |
$927.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.89
|
| Rate for Payer: Railroad Medicare Medicare |
$918.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,233.52
|
| Rate for Payer: UHC Core |
$3,068.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.62
|
| Rate for Payer: UHC Exchange |
$918.62
|
| Rate for Payer: UHC Medicare Advantage |
$918.62
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$918.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.84
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,674.46
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,388.40 |
| Max. Negotiated Rate |
$3,307.01 |
| Rate for Payer: Aetna Commercial |
$3,123.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,999.46
|
| Rate for Payer: BCN Commercial |
$2,839.62
|
| Rate for Payer: Cash Price |
$2,939.57
|
| Rate for Payer: Cofinity Commercial |
$3,160.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.57
|
| Rate for Payer: Healthscope Commercial |
$3,307.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,123.29
|
| Rate for Payer: Nomi Health Commercial |
$3,013.06
|
| Rate for Payer: PHP Commercial |
$3,123.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,388.40
|
| Rate for Payer: Priority Health HMO/PPO |
$3,196.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,233.52
|
| Rate for Payer: UHC Core |
$3,068.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.84
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.19 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna Medicare |
$238.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.10
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$229.68
|
| Rate for Payer: BCBS Trust/PPO |
$755.27
|
| Rate for Payer: BCN Commercial |
$714.30
|
| Rate for Payer: BCN Medicare Advantage |
$229.68
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.68
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.16
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PACE Senior Care Partners |
$218.19
|
| Rate for Payer: PACE SWMI |
$229.68
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: PHP Medicare Advantage |
$229.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO |
$799.28
|
| Rate for Payer: Priority Health Medicare |
$231.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.54
|
| Rate for Payer: Railroad Medicare Medicare |
$229.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.46
|
| Rate for Payer: UHC Core |
$767.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.68
|
| Rate for Payer: UHC Exchange |
$229.68
|
| Rate for Payer: UHC Medicare Advantage |
$229.68
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$229.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$597.16 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: BCBS Trust/PPO |
$749.94
|
| Rate for Payer: BCN Commercial |
$709.98
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO |
$799.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.46
|
| Rate for Payer: UHC Core |
$767.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$658.55 |
| Max. Negotiated Rate |
$911.84 |
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: BCBS Trust/PPO |
$827.03
|
| Rate for Payer: BCN Commercial |
$782.96
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$759.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: Nomi Health Commercial |
$830.78
|
| Rate for Payer: PHP Commercial |
$861.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health HMO/PPO |
$881.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$678.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.57
|
| Rate for Payer: UHC Core |
$845.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$759.86
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,013.15
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$240.62 |
| Max. Negotiated Rate |
$911.84 |
| Rate for Payer: Aetna Commercial |
$861.18
|
| Rate for Payer: Aetna Medicare |
$263.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$316.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$316.61
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$253.29
|
| Rate for Payer: BCBS Trust/PPO |
$832.91
|
| Rate for Payer: BCN Commercial |
$787.72
|
| Rate for Payer: BCN Medicare Advantage |
$253.29
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cash Price |
$810.52
|
| Rate for Payer: Cofinity Commercial |
$871.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$810.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.29
|
| Rate for Payer: Healthscope Commercial |
$911.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$759.86
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.95
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$861.18
|
| Rate for Payer: Nomi Health Commercial |
$830.78
|
| Rate for Payer: PACE Senior Care Partners |
$240.62
|
| Rate for Payer: PACE SWMI |
$253.29
|
| Rate for Payer: PHP Commercial |
$861.18
|
| Rate for Payer: PHP Medicare Advantage |
$253.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$658.55
|
| Rate for Payer: Priority Health HMO/PPO |
$881.44
|
| Rate for Payer: Priority Health Medicare |
$255.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$678.81
|
| Rate for Payer: Railroad Medicare Medicare |
$253.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$891.57
|
| Rate for Payer: UHC Core |
$845.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.29
|
| Rate for Payer: UHC Exchange |
$253.29
|
| Rate for Payer: UHC Medicare Advantage |
$253.29
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$253.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$759.86
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,224.77 |
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: Aetna Medicare |
$353.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$425.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$425.27
|
| Rate for Payer: BCBS Complete |
$599.81
|
| Rate for Payer: BCBS MAPPO |
$340.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.75
|
| Rate for Payer: BCN Commercial |
$1,058.06
|
| Rate for Payer: BCN Medicare Advantage |
$340.21
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.21
|
| Rate for Payer: Healthscope Commercial |
$1,224.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.64
|
| Rate for Payer: Mclaren Medicaid |
$571.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.22
|
| Rate for Payer: Meridian Medicaid |
$599.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$1,115.90
|
| Rate for Payer: PACE Senior Care Partners |
$323.20
|
| Rate for Payer: PACE SWMI |
$340.21
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| Rate for Payer: PHP Medicare Advantage |
$340.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,183.94
|
| Rate for Payer: Priority Health Medicare |
$343.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$911.77
|
| Rate for Payer: Railroad Medicare Medicare |
$340.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,197.55
|
| Rate for Payer: UHC Core |
$1,136.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.21
|
| Rate for Payer: UHC Exchange |
$340.21
|
| Rate for Payer: UHC Medicare Advantage |
$340.21
|
| Rate for Payer: UHCCP Medicaid |
$571.21
|
| Rate for Payer: VA VA |
$340.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.64
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,360.85
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$884.55 |
| Max. Negotiated Rate |
$1,224.77 |
| Rate for Payer: Aetna Commercial |
$1,156.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,110.86
|
| Rate for Payer: BCN Commercial |
$1,051.66
|
| Rate for Payer: Cash Price |
$1,088.68
|
| Rate for Payer: Cofinity Commercial |
$1,170.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,088.68
|
| Rate for Payer: Healthscope Commercial |
$1,224.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,020.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,156.72
|
| Rate for Payer: Nomi Health Commercial |
$1,115.90
|
| Rate for Payer: PHP Commercial |
$1,156.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$884.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,183.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$911.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,197.55
|
| Rate for Payer: UHC Core |
$1,136.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,020.64
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$45.93
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.85 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: BCBS Trust/PPO |
$37.49
|
| Rate for Payer: BCN Commercial |
$35.49
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: Nomi Health Commercial |
$37.66
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health HMO/PPO |
$39.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.42
|
| Rate for Payer: UHC Core |
$38.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.45
|
|
