|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,639.72 |
| Max. Negotiated Rate |
$10,003.15 |
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: Aetna Medicare |
$2,889.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.32
|
| Rate for Payer: BCBS Complete |
$4,328.59
|
| Rate for Payer: BCBS MAPPO |
$2,778.65
|
| Rate for Payer: BCBS Trust/PPO |
$9,137.32
|
| Rate for Payer: BCN Commercial |
$8,641.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.65
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.65
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Mclaren Medicaid |
$4,122.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,917.59
|
| Rate for Payer: Meridian Medicaid |
$4,328.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: Nomi Health Commercial |
$9,113.98
|
| Rate for Payer: PACE Senior Care Partners |
$2,639.72
|
| Rate for Payer: PACE SWMI |
$2,778.65
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health HMO/PPO |
$9,669.71
|
| Rate for Payer: Priority Health Medicare |
$2,806.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,446.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,780.86
|
| Rate for Payer: UHC Core |
$9,280.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.65
|
| Rate for Payer: UHC Exchange |
$2,778.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,778.65
|
| Rate for Payer: UHCCP Medicaid |
$4,122.20
|
| Rate for Payer: VA VA |
$2,778.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,224.50 |
| Max. Negotiated Rate |
$10,003.15 |
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: BCBS Trust/PPO |
$9,072.86
|
| Rate for Payer: BCN Commercial |
$8,589.37
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: Nomi Health Commercial |
$9,113.98
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health HMO/PPO |
$9,669.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,446.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,780.86
|
| Rate for Payer: UHC Core |
$9,280.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,715.44 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: Aetna Medicare |
$1,877.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,257.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,257.16
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: BCBS MAPPO |
$1,805.72
|
| Rate for Payer: BCBS Trust/PPO |
$5,937.95
|
| Rate for Payer: BCN Commercial |
$5,615.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,805.72
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,805.72
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,896.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,076.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,715.44
|
| Rate for Payer: PACE SWMI |
$1,805.72
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,805.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.92
|
| Rate for Payer: Priority Health Medicare |
$1,823.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,805.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,356.15
|
| Rate for Payer: UHC Core |
$6,031.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,805.72
|
| Rate for Payer: UHC Exchange |
$1,805.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,805.72
|
| Rate for Payer: VA VA |
$1,805.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,694.89 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna Commercial |
$6,139.47
|
| Rate for Payer: BCBS Trust/PPO |
$5,896.05
|
| Rate for Payer: BCN Commercial |
$5,581.86
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.47
|
| Rate for Payer: Nomi Health Commercial |
$5,922.78
|
| Rate for Payer: PHP Commercial |
$6,139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.89
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,356.15
|
| Rate for Payer: UHC Core |
$6,031.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,949.27 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna Medicare |
$3,228.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,880.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,880.62
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$3,104.50
|
| Rate for Payer: BCBS Trust/PPO |
$10,208.83
|
| Rate for Payer: BCN Commercial |
$9,654.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,104.50
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,104.50
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,259.72
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,570.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: PACE Senior Care Partners |
$2,949.27
|
| Rate for Payer: PACE SWMI |
$3,104.50
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,104.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health HMO/PPO |
$10,803.65
|
| Rate for Payer: Priority Health Medicare |
$3,135.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,320.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,104.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,927.83
|
| Rate for Payer: UHC Core |
$10,369.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,104.50
|
| Rate for Payer: UHC Exchange |
$3,104.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,104.50
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$3,104.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,071.69 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: BCBS Trust/PPO |
$10,136.81
|
| Rate for Payer: BCN Commercial |
$9,596.62
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$10,182.75
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health HMO/PPO |
$10,803.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,320.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,927.83
|
| Rate for Payer: UHC Core |
$10,369.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,255.28 |
| Max. Negotiated Rate |
$12,335.81 |
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: Aetna Medicare |
$3,563.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,283.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,283.27
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$3,426.61
|
| Rate for Payer: BCBS Trust/PPO |
$11,268.08
|
| Rate for Payer: BCN Commercial |
$10,656.77
|
| Rate for Payer: BCN Medicare Advantage |
$3,426.61
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,426.61
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,597.95
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,940.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: Nomi Health Commercial |
$11,239.30
|
| Rate for Payer: PACE Senior Care Partners |
$3,255.28
|
| Rate for Payer: PACE SWMI |
$3,426.61
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: PHP Medicare Advantage |
$3,426.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health HMO/PPO |
$11,924.62
|
| Rate for Payer: Priority Health Medicare |
$3,460.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,183.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3,426.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,061.68
|
| Rate for Payer: UHC Core |
$11,444.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,426.61
|
| Rate for Payer: UHC Exchange |
$3,426.61
|
| Rate for Payer: UHC Medicare Advantage |
$3,426.61
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$3,426.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,909.20 |
| Max. Negotiated Rate |
$12,335.81 |
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: BCBS Trust/PPO |
$11,188.58
|
| Rate for Payer: BCN Commercial |
$10,592.35
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: Nomi Health Commercial |
$11,239.30
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health HMO/PPO |
$11,924.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,183.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,061.68
|
| Rate for Payer: UHC Core |
$11,444.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,929.63 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: BCBS Trust/PPO |
$6,190.85
|
| Rate for Payer: BCN Commercial |
$5,860.95
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Nomi Health Commercial |
$6,218.91
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health HMO/PPO |
$6,598.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,081.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,673.96
|
| Rate for Payer: UHC Core |
$6,332.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,801.21 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna Medicare |
$1,971.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,370.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,370.01
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: BCBS MAPPO |
$1,896.01
|
| Rate for Payer: BCBS Trust/PPO |
$6,234.84
|
| Rate for Payer: BCN Commercial |
$5,896.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,896.01
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,896.01
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,990.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,180.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: Nomi Health Commercial |
$6,218.91
|
| Rate for Payer: PACE Senior Care Partners |
$1,801.21
|
| Rate for Payer: PACE SWMI |
$1,896.01
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,896.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health HMO/PPO |
$6,598.11
|
| Rate for Payer: Priority Health Medicare |
$1,914.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,081.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,896.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,673.96
|
| Rate for Payer: UHC Core |
$6,332.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,896.01
|
| Rate for Payer: UHC Exchange |
$1,896.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,896.01
|
| Rate for Payer: VA VA |
$1,896.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,939.35 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: Aetna Medicare |
$3,217.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,867.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,867.57
|
| Rate for Payer: BCBS Complete |
$4,950.48
|
| Rate for Payer: BCBS MAPPO |
$3,094.05
|
| Rate for Payer: BCBS Trust/PPO |
$10,174.48
|
| Rate for Payer: BCN Commercial |
$9,622.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,094.05
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,094.05
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,248.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,558.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: Nomi Health Commercial |
$10,148.49
|
| Rate for Payer: PACE Senior Care Partners |
$2,939.35
|
| Rate for Payer: PACE SWMI |
$3,094.05
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: PHP Medicare Advantage |
$3,094.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health HMO/PPO |
$10,767.30
|
| Rate for Payer: Priority Health Medicare |
$3,124.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,292.06
|
| Rate for Payer: Railroad Medicare Medicare |
$3,094.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,891.06
|
| Rate for Payer: UHC Core |
$10,334.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,094.05
|
| Rate for Payer: UHC Exchange |
$3,094.05
|
| Rate for Payer: UHC Medicare Advantage |
$3,094.05
|
| Rate for Payer: VA VA |
$3,094.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,044.54 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: BCBS Trust/PPO |
$10,102.70
|
| Rate for Payer: BCN Commercial |
$9,564.34
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: Nomi Health Commercial |
$10,148.49
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health HMO/PPO |
$10,767.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,292.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,891.06
|
| Rate for Payer: UHC Core |
$10,334.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,837.32 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: BCBS Trust/PPO |
$8,586.62
|
| Rate for Payer: BCN Commercial |
$8,129.04
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Nomi Health Commercial |
$8,625.54
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health HMO/PPO |
$9,151.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,047.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,256.68
|
| Rate for Payer: UHC Core |
$8,783.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,498.25 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$2,734.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,287.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,287.17
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: BCBS MAPPO |
$2,629.74
|
| Rate for Payer: BCBS Trust/PPO |
$8,647.63
|
| Rate for Payer: BCN Commercial |
$8,178.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,629.74
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,629.74
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,761.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,024.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: Nomi Health Commercial |
$8,625.54
|
| Rate for Payer: PACE Senior Care Partners |
$2,498.25
|
| Rate for Payer: PACE SWMI |
$2,629.74
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,629.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health HMO/PPO |
$9,151.49
|
| Rate for Payer: Priority Health Medicare |
$2,656.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,047.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2,629.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,256.68
|
| Rate for Payer: UHC Core |
$8,783.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,629.74
|
| Rate for Payer: UHC Exchange |
$2,629.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,629.74
|
| Rate for Payer: VA VA |
$2,629.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,703.70 |
| Max. Negotiated Rate |
$10,245.58 |
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: Aetna Medicare |
$2,959.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,557.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,557.49
|
| Rate for Payer: BCBS Complete |
$4,328.59
|
| Rate for Payer: BCBS MAPPO |
$2,845.99
|
| Rate for Payer: BCBS Trust/PPO |
$9,358.77
|
| Rate for Payer: BCN Commercial |
$8,851.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,845.99
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,845.99
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.99
|
| Rate for Payer: Mclaren Medicaid |
$4,122.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,988.29
|
| Rate for Payer: Meridian Medicaid |
$4,328.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,272.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: Nomi Health Commercial |
$9,334.86
|
| Rate for Payer: PACE Senior Care Partners |
$2,703.70
|
| Rate for Payer: PACE SWMI |
$2,845.99
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,845.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health HMO/PPO |
$9,904.06
|
| Rate for Payer: Priority Health Medicare |
$2,874.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,627.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,845.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,017.90
|
| Rate for Payer: UHC Core |
$9,505.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,845.99
|
| Rate for Payer: UHC Exchange |
$2,845.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,845.99
|
| Rate for Payer: UHCCP Medicaid |
$4,122.20
|
| Rate for Payer: VA VA |
$2,845.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.99
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,399.59 |
| Max. Negotiated Rate |
$10,245.58 |
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: BCBS Trust/PPO |
$9,292.74
|
| Rate for Payer: BCN Commercial |
$8,797.54
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: Nomi Health Commercial |
$9,334.86
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health HMO/PPO |
$9,904.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,627.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,017.90
|
| Rate for Payer: UHC Core |
$9,505.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.99
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$118.46 |
| Max. Negotiated Rate |
$164.03 |
| Rate for Payer: Aetna Commercial |
$154.91
|
| Rate for Payer: BCBS Trust/PPO |
$148.77
|
| Rate for Payer: BCN Commercial |
$140.84
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$156.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Healthscope Commercial |
$164.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: PHP Commercial |
$154.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: Priority Health HMO/PPO |
$158.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.38
|
| Rate for Payer: UHC Core |
$152.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.69
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$182.25
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$164.03 |
| Rate for Payer: Aetna Commercial |
$154.91
|
| Rate for Payer: Aetna Medicare |
$47.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.95
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$45.56
|
| Rate for Payer: BCBS Trust/PPO |
$149.83
|
| Rate for Payer: BCN Commercial |
$141.70
|
| Rate for Payer: BCN Medicare Advantage |
$45.56
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cash Price |
$145.80
|
| Rate for Payer: Cofinity Commercial |
$156.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.56
|
| Rate for Payer: Healthscope Commercial |
$164.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.69
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.84
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.91
|
| Rate for Payer: Nomi Health Commercial |
$149.44
|
| Rate for Payer: PACE Senior Care Partners |
$43.28
|
| Rate for Payer: PACE SWMI |
$45.56
|
| Rate for Payer: PHP Commercial |
$154.91
|
| Rate for Payer: PHP Medicare Advantage |
$45.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.46
|
| Rate for Payer: Priority Health HMO/PPO |
$158.56
|
| Rate for Payer: Priority Health Medicare |
$46.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.11
|
| Rate for Payer: Railroad Medicare Medicare |
$45.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.38
|
| Rate for Payer: UHC Core |
$152.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.56
|
| Rate for Payer: UHC Exchange |
$45.56
|
| Rate for Payer: UHC Medicare Advantage |
$45.56
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$45.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.69
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna Commercial |
$37.07
|
| Rate for Payer: Aetna Medicare |
$11.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.63
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$10.90
|
| Rate for Payer: BCBS Trust/PPO |
$35.85
|
| Rate for Payer: BCN Commercial |
$33.91
|
| Rate for Payer: BCN Medicare Advantage |
$10.90
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$37.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.90
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: Nomi Health Commercial |
$35.76
|
| Rate for Payer: PACE Senior Care Partners |
$10.36
|
| Rate for Payer: PACE SWMI |
$10.90
|
| Rate for Payer: PHP Commercial |
$37.07
|
| Rate for Payer: PHP Medicare Advantage |
$10.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: Priority Health HMO/PPO |
$37.94
|
| Rate for Payer: Priority Health Medicare |
$11.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.22
|
| Rate for Payer: Railroad Medicare Medicare |
$10.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.38
|
| Rate for Payer: UHC Core |
$36.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.90
|
| Rate for Payer: UHC Exchange |
$10.90
|
| Rate for Payer: UHC Medicare Advantage |
$10.90
|
| Rate for Payer: VA VA |
$10.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.71
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$43.61
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$39.25 |
| Rate for Payer: Aetna Commercial |
$37.07
|
| Rate for Payer: BCBS Trust/PPO |
$35.60
|
| Rate for Payer: BCN Commercial |
$33.70
|
| Rate for Payer: Cash Price |
$34.89
|
| Rate for Payer: Cofinity Commercial |
$37.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.89
|
| Rate for Payer: Healthscope Commercial |
$39.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.07
|
| Rate for Payer: Nomi Health Commercial |
$35.76
|
| Rate for Payer: PHP Commercial |
$37.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.35
|
| Rate for Payer: Priority Health HMO/PPO |
$37.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.38
|
| Rate for Payer: UHC Core |
$36.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.71
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$361.15
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.75 |
| Max. Negotiated Rate |
$325.04 |
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: BCBS Trust/PPO |
$294.81
|
| Rate for Payer: BCN Commercial |
$279.10
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health HMO/PPO |
$314.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.81
|
| Rate for Payer: UHC Core |
$301.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$361.15
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.77 |
| Max. Negotiated Rate |
$325.04 |
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna Medicare |
$93.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.86
|
| Rate for Payer: BCBS Complete |
$184.65
|
| Rate for Payer: BCBS MAPPO |
$90.29
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$280.79
|
| Rate for Payer: BCN Medicare Advantage |
$90.29
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.29
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Mclaren Medicaid |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.80
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: Nomi Health Commercial |
$296.14
|
| Rate for Payer: PACE Senior Care Partners |
$85.77
|
| Rate for Payer: PACE SWMI |
$90.29
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: PHP Medicare Advantage |
$90.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health HMO/PPO |
$314.20
|
| Rate for Payer: Priority Health Medicare |
$91.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.97
|
| Rate for Payer: Railroad Medicare Medicare |
$90.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.81
|
| Rate for Payer: UHC Core |
$301.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.29
|
| Rate for Payer: UHC Exchange |
$90.29
|
| Rate for Payer: UHC Medicare Advantage |
$90.29
|
| Rate for Payer: UHCCP Medicaid |
$175.84
|
| Rate for Payer: VA VA |
$90.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$18.07
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.75 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: BCBS Trust/PPO |
$14.75
|
| Rate for Payer: BCN Commercial |
$13.96
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health HMO/PPO |
$15.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.90
|
| Rate for Payer: UHC Core |
$15.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.55
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$18.07
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS Trust/PPO |
$14.86
|
| Rate for Payer: BCN Commercial |
$14.05
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: Nomi Health Commercial |
$14.82
|
| Rate for Payer: PACE Senior Care Partners |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health HMO/PPO |
$15.72
|
| Rate for Payer: Priority Health Medicare |
$4.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.11
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.90
|
| Rate for Payer: UHC Core |
$15.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.52
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UHC Medicare Advantage |
$4.52
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.55
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,959.74
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$465.44 |
| Max. Negotiated Rate |
$1,763.77 |
| Rate for Payer: Aetna Commercial |
$1,665.78
|
| Rate for Payer: Aetna Medicare |
$509.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.42
|
| Rate for Payer: BCBS Complete |
$783.90
|
| Rate for Payer: BCBS MAPPO |
$489.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.10
|
| Rate for Payer: BCN Commercial |
$1,523.70
|
| Rate for Payer: BCN Medicare Advantage |
$489.94
|
| Rate for Payer: Cash Price |
$1,567.79
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.94
|
| Rate for Payer: Healthscope Commercial |
$1,763.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.78
|
| Rate for Payer: Nomi Health Commercial |
$1,606.99
|
| Rate for Payer: PACE Senior Care Partners |
$465.44
|
| Rate for Payer: PACE SWMI |
$489.94
|
| Rate for Payer: PHP Commercial |
$1,665.78
|
| Rate for Payer: PHP Medicare Advantage |
$489.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.97
|
| Rate for Payer: Priority Health Medicare |
$494.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,313.03
|
| Rate for Payer: Railroad Medicare Medicare |
$489.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.57
|
| Rate for Payer: UHC Core |
$1,636.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.94
|
| Rate for Payer: UHC Exchange |
$489.94
|
| Rate for Payer: UHC Medicare Advantage |
$489.94
|
| Rate for Payer: VA VA |
$489.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
