|
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
|
|
|
HC IR SHEATH
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$60.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.15
|
| Rate for Payer: BCBS Complete |
$93.64
|
| Rate for Payer: BCBS MAPPO |
$58.52
|
| Rate for Payer: BCBS Trust/PPO |
$192.45
|
| Rate for Payer: BCN Commercial |
$182.00
|
| Rate for Payer: BCN Medicare Advantage |
$58.52
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.52
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: PACE Senior Care Partners |
$55.60
|
| Rate for Payer: PACE SWMI |
$58.52
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: PHP Medicare Advantage |
$58.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Medicare |
$59.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.84
|
| Rate for Payer: Railroad Medicare Medicare |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.52
|
| Rate for Payer: UHC Exchange |
$58.52
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: VA VA |
$58.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$191.09
|
| Rate for Payer: BCN Commercial |
$180.90
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$729.07
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna Commercial |
$619.71
|
| Rate for Payer: Aetna Medicare |
$189.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.83
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$182.27
|
| Rate for Payer: BCBS Trust/PPO |
$599.37
|
| Rate for Payer: BCN Commercial |
$566.85
|
| Rate for Payer: BCN Medicare Advantage |
$182.27
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cofinity Commercial |
$627.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.27
|
| Rate for Payer: Healthscope Commercial |
$656.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.80
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.38
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.71
|
| Rate for Payer: Nomi Health Commercial |
$597.84
|
| Rate for Payer: PACE Senior Care Partners |
$173.15
|
| Rate for Payer: PACE SWMI |
$182.27
|
| Rate for Payer: PHP Commercial |
$619.71
|
| Rate for Payer: PHP Medicare Advantage |
$182.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health HMO/PPO |
$634.29
|
| Rate for Payer: Priority Health Medicare |
$184.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.48
|
| Rate for Payer: Railroad Medicare Medicare |
$182.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.58
|
| Rate for Payer: UHC Core |
$608.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.27
|
| Rate for Payer: UHC Exchange |
$182.27
|
| Rate for Payer: UHC Medicare Advantage |
$182.27
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$182.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.80
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$729.07
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$473.90 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna Commercial |
$619.71
|
| Rate for Payer: BCBS Trust/PPO |
$595.14
|
| Rate for Payer: BCN Commercial |
$563.43
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cofinity Commercial |
$627.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.26
|
| Rate for Payer: Healthscope Commercial |
$656.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.71
|
| Rate for Payer: Nomi Health Commercial |
$597.84
|
| Rate for Payer: PHP Commercial |
$619.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health HMO/PPO |
$634.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.58
|
| Rate for Payer: UHC Core |
$608.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.80
|
|
|
HC IR SIALOGRAM
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 SIALOGRAM
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$975.38
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$231.65 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna Medicare |
$253.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$304.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$304.81
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$243.84
|
| Rate for Payer: BCBS Trust/PPO |
$801.86
|
| Rate for Payer: BCN Commercial |
$758.36
|
| Rate for Payer: BCN Medicare Advantage |
$243.84
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.84
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.53
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.04
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: Nomi Health Commercial |
$799.81
|
| Rate for Payer: PACE Senior Care Partners |
$231.65
|
| Rate for Payer: PACE SWMI |
$243.84
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$243.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health HMO/PPO |
$848.58
|
| Rate for Payer: Priority Health Medicare |
$246.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.50
|
| Rate for Payer: Railroad Medicare Medicare |
$243.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.33
|
| Rate for Payer: UHC Core |
$814.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.84
|
| Rate for Payer: UHC Exchange |
$243.84
|
| Rate for Payer: UHC Medicare Advantage |
$243.84
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$243.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.53
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$975.38
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.00 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$796.20
|
| Rate for Payer: BCN Commercial |
$753.77
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: Nomi Health Commercial |
$799.81
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health HMO/PPO |
$848.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.33
|
| Rate for Payer: UHC Core |
$814.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.53
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: BCBS Trust/PPO |
$333.21
|
| Rate for Payer: BCN Commercial |
$315.46
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$96.95 |
| Max. Negotiated Rate |
$416.27 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$106.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.56
|
| Rate for Payer: BCBS Complete |
$416.27
|
| Rate for Payer: BCBS MAPPO |
$102.05
|
| Rate for Payer: BCBS Trust/PPO |
$335.58
|
| Rate for Payer: BCN Commercial |
$317.38
|
| Rate for Payer: BCN Medicare Advantage |
$102.05
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.05
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$396.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$416.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PACE Senior Care Partners |
$96.95
|
| Rate for Payer: PACE SWMI |
$102.05
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$102.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Medicare |
$103.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: Railroad Medicare Medicare |
$102.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.05
|
| Rate for Payer: UHC Exchange |
$102.05
|
| Rate for Payer: UHC Medicare Advantage |
$102.05
|
| Rate for Payer: UHCCP Medicaid |
$396.42
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$372.41 |
| Max. Negotiated Rate |
$1,411.24 |
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: Aetna Medicare |
$407.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.01
|
| Rate for Payer: BCBS Complete |
$627.22
|
| Rate for Payer: BCBS MAPPO |
$392.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.09
|
| Rate for Payer: BCN Commercial |
$1,219.15
|
| Rate for Payer: BCN Medicare Advantage |
$392.01
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.01
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: PACE Senior Care Partners |
$372.41
|
| Rate for Payer: PACE SWMI |
$392.01
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: PHP Medicare Advantage |
$392.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.19
|
| Rate for Payer: Priority Health Medicare |
$395.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.59
|
| Rate for Payer: Railroad Medicare Medicare |
$392.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.88
|
| Rate for Payer: UHC Core |
$1,309.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.01
|
| Rate for Payer: UHC Exchange |
$392.01
|
| Rate for Payer: UHC Medicare Advantage |
$392.01
|
| Rate for Payer: VA VA |
$392.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,019.23 |
| Max. Negotiated Rate |
$1,411.24 |
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.99
|
| Rate for Payer: BCN Commercial |
$1,211.78
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.88
|
| Rate for Payer: UHC Core |
$1,309.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$902.90 |
| Max. Negotiated Rate |
$4,104.01 |
| Rate for Payer: Aetna Commercial |
$3,231.42
|
| Rate for Payer: Aetna Medicare |
$988.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,188.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,188.02
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$950.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,125.35
|
| Rate for Payer: BCN Commercial |
$2,955.80
|
| Rate for Payer: BCN Medicare Advantage |
$950.42
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,269.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.42
|
| Rate for Payer: Healthscope Commercial |
$3,421.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.25
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.94
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,092.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| Rate for Payer: PACE Senior Care Partners |
$902.90
|
| Rate for Payer: PACE SWMI |
$950.42
|
| Rate for Payer: PHP Commercial |
$3,231.42
|
| Rate for Payer: PHP Medicare Advantage |
$950.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health HMO/PPO |
$3,307.45
|
| Rate for Payer: Priority Health Medicare |
$959.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,547.12
|
| Rate for Payer: Railroad Medicare Medicare |
$950.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,345.47
|
| Rate for Payer: UHC Core |
$3,174.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.42
|
| Rate for Payer: UHC Exchange |
$950.42
|
| Rate for Payer: UHC Medicare Advantage |
$950.42
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$950.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,471.09 |
| Max. Negotiated Rate |
$3,421.50 |
| Rate for Payer: Aetna Commercial |
$3,231.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,103.30
|
| Rate for Payer: BCN Commercial |
$2,937.93
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,269.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Healthscope Commercial |
$3,421.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: Nomi Health Commercial |
$3,117.37
|
| Rate for Payer: PHP Commercial |
$3,231.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health HMO/PPO |
$3,307.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,547.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,345.47
|
| Rate for Payer: UHC Core |
$3,174.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$630.37 |
| Max. Negotiated Rate |
$2,388.79 |
| Rate for Payer: Aetna Commercial |
$2,256.08
|
| Rate for Payer: Aetna Medicare |
$690.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$829.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$829.44
|
| Rate for Payer: BCBS Complete |
$1,179.37
|
| Rate for Payer: BCBS MAPPO |
$663.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,182.03
|
| Rate for Payer: BCN Commercial |
$2,063.65
|
| Rate for Payer: BCN Medicare Advantage |
$663.55
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$2,282.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.55
|
| Rate for Payer: Healthscope Commercial |
$2,388.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,990.66
|
| Rate for Payer: Mclaren Medicaid |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.73
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$763.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: Nomi Health Commercial |
$2,176.45
|
| Rate for Payer: PACE Senior Care Partners |
$630.37
|
| Rate for Payer: PACE SWMI |
$663.55
|
| Rate for Payer: PHP Commercial |
$2,256.08
|
| Rate for Payer: PHP Medicare Advantage |
$663.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,123.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: Priority Health HMO/PPO |
$2,309.16
|
| Rate for Payer: Priority Health Medicare |
$670.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,778.32
|
| Rate for Payer: Railroad Medicare Medicare |
$663.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,335.70
|
| Rate for Payer: UHC Core |
$2,216.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$663.55
|
| Rate for Payer: UHC Exchange |
$663.55
|
| Rate for Payer: UHC Medicare Advantage |
$663.55
|
| Rate for Payer: UHCCP Medicaid |
$1,123.14
|
| Rate for Payer: VA VA |
$663.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,990.66
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,725.24 |
| Max. Negotiated Rate |
$2,388.79 |
| Rate for Payer: Aetna Commercial |
$2,256.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,166.63
|
| Rate for Payer: BCN Commercial |
$2,051.17
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$2,282.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Healthscope Commercial |
$2,388.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,990.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: Nomi Health Commercial |
$2,176.45
|
| Rate for Payer: PHP Commercial |
$2,256.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: Priority Health HMO/PPO |
$2,309.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,778.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,335.70
|
| Rate for Payer: UHC Core |
$2,216.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,990.66
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,009.95 |
| Max. Negotiated Rate |
$13,632.74 |
| Rate for Payer: Aetna Commercial |
$7,193.52
|
| Rate for Payer: Aetna Medicare |
$2,200.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,644.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,644.68
|
| Rate for Payer: BCBS Complete |
$13,632.74
|
| Rate for Payer: BCBS MAPPO |
$2,115.74
|
| Rate for Payer: BCBS Trust/PPO |
$6,957.40
|
| Rate for Payer: BCN Commercial |
$6,579.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,115.74
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$7,278.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,115.74
|
| Rate for Payer: Healthscope Commercial |
$7,616.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,347.22
|
| Rate for Payer: Mclaren Medicaid |
$12,982.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,221.53
|
| Rate for Payer: Meridian Medicaid |
$13,632.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,433.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,193.52
|
| Rate for Payer: Nomi Health Commercial |
$6,939.63
|
| Rate for Payer: PACE Senior Care Partners |
$2,009.95
|
| Rate for Payer: PACE SWMI |
$2,115.74
|
| Rate for Payer: PHP Commercial |
$7,193.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,115.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,982.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,500.92
|
| Rate for Payer: Priority Health HMO/PPO |
$7,362.78
|
| Rate for Payer: Priority Health Medicare |
$2,136.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,670.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,115.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,447.40
|
| Rate for Payer: UHC Core |
$7,066.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,115.74
|
| Rate for Payer: UHC Exchange |
$2,115.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,115.74
|
| Rate for Payer: UHCCP Medicaid |
$12,982.71
|
| Rate for Payer: VA VA |
$2,115.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,347.22
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,500.92 |
| Max. Negotiated Rate |
$7,616.66 |
| Rate for Payer: Aetna Commercial |
$7,193.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,908.31
|
| Rate for Payer: BCN Commercial |
$6,540.18
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$7,278.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Healthscope Commercial |
$7,616.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,347.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,193.52
|
| Rate for Payer: Nomi Health Commercial |
$6,939.63
|
| Rate for Payer: PHP Commercial |
$7,193.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,500.92
|
| Rate for Payer: Priority Health HMO/PPO |
$7,362.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,670.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,447.40
|
| Rate for Payer: UHC Core |
$7,066.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,347.22
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,562.46 |
| Max. Negotiated Rate |
$2,163.41 |
| Rate for Payer: Aetna Commercial |
$2,043.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.21
|
| Rate for Payer: BCN Commercial |
$1,857.65
|
| Rate for Payer: Cash Price |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$2,067.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.03
|
| Rate for Payer: Healthscope Commercial |
$2,163.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,802.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.22
|
| Rate for Payer: Nomi Health Commercial |
$1,971.11
|
| Rate for Payer: PHP Commercial |
$2,043.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.46
|
| Rate for Payer: Priority Health HMO/PPO |
$2,091.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,610.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,115.34
|
| Rate for Payer: UHC Core |
$2,007.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,802.84
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.90 |
| Max. Negotiated Rate |
$2,163.41 |
| Rate for Payer: Aetna Commercial |
$2,043.22
|
| Rate for Payer: Aetna Medicare |
$624.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$751.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$751.18
|
| Rate for Payer: BCBS Complete |
$961.52
|
| Rate for Payer: BCBS MAPPO |
$600.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.16
|
| Rate for Payer: BCN Commercial |
$1,868.95
|
| Rate for Payer: BCN Medicare Advantage |
$600.95
|
| Rate for Payer: Cash Price |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$2,067.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.95
|
| Rate for Payer: Healthscope Commercial |
$2,163.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,802.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$691.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.22
|
| Rate for Payer: Nomi Health Commercial |
$1,971.11
|
| Rate for Payer: PACE Senior Care Partners |
$570.90
|
| Rate for Payer: PACE SWMI |
$600.95
|
| Rate for Payer: PHP Commercial |
$2,043.22
|
| Rate for Payer: PHP Medicare Advantage |
$600.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.46
|
| Rate for Payer: Priority Health HMO/PPO |
$2,091.30
|
| Rate for Payer: Priority Health Medicare |
$606.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,610.54
|
| Rate for Payer: Railroad Medicare Medicare |
$600.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,115.34
|
| Rate for Payer: UHC Core |
$2,007.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.95
|
| Rate for Payer: UHC Exchange |
$600.95
|
| Rate for Payer: UHC Medicare Advantage |
$600.95
|
| Rate for Payer: VA VA |
$600.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,802.84
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,716.73 |
| Max. Negotiated Rate |
$5,146.24 |
| Rate for Payer: Aetna Commercial |
$4,860.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,667.64
|
| Rate for Payer: BCN Commercial |
$4,418.90
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$4,917.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Healthscope Commercial |
$5,146.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,288.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: Nomi Health Commercial |
$4,688.79
|
| Rate for Payer: PHP Commercial |
$4,860.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: Priority Health HMO/PPO |
$4,974.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,831.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,031.88
|
| Rate for Payer: UHC Core |
$4,774.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,288.53
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,358.03 |
| Max. Negotiated Rate |
$5,146.24 |
| Rate for Payer: Aetna Commercial |
$4,860.33
|
| Rate for Payer: Aetna Medicare |
$1,486.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,786.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,786.89
|
| Rate for Payer: BCBS Complete |
$2,287.22
|
| Rate for Payer: BCBS MAPPO |
$1,429.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,700.80
|
| Rate for Payer: BCN Commercial |
$4,445.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,429.51
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$4,917.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,429.51
|
| Rate for Payer: Healthscope Commercial |
$5,146.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,288.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,500.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,643.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: Nomi Health Commercial |
$4,688.79
|
| Rate for Payer: PACE Senior Care Partners |
$1,358.03
|
| Rate for Payer: PACE SWMI |
$1,429.51
|
| Rate for Payer: PHP Commercial |
$4,860.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,429.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: Priority Health HMO/PPO |
$4,974.69
|
| Rate for Payer: Priority Health Medicare |
$1,443.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,831.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,429.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,031.88
|
| Rate for Payer: UHC Core |
$4,774.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,429.51
|
| Rate for Payer: UHC Exchange |
$1,429.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,429.51
|
| Rate for Payer: VA VA |
$1,429.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,288.53
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,767.53 |
| Max. Negotiated Rate |
$8,609.76 |
| Rate for Payer: Aetna Commercial |
$6,325.91
|
| Rate for Payer: Aetna Medicare |
$1,934.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,325.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,325.70
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$1,860.56
|
| Rate for Payer: BCBS Trust/PPO |
$6,118.27
|
| Rate for Payer: BCN Commercial |
$5,786.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,860.56
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$6,400.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,860.56
|
| Rate for Payer: Healthscope Commercial |
$6,698.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,581.69
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,953.59
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,139.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,325.91
|
| Rate for Payer: Nomi Health Commercial |
$6,102.65
|
| Rate for Payer: PACE Senior Care Partners |
$1,767.53
|
| Rate for Payer: PACE SWMI |
$1,860.56
|
| Rate for Payer: PHP Commercial |
$6,325.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,860.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,837.46
|
| Rate for Payer: Priority Health HMO/PPO |
$6,474.76
|
| Rate for Payer: Priority Health Medicare |
$1,879.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,986.31
|
| Rate for Payer: Railroad Medicare Medicare |
$1,860.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,549.18
|
| Rate for Payer: UHC Core |
$6,214.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,860.56
|
| Rate for Payer: UHC Exchange |
$1,860.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,860.56
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$1,860.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,581.69
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,837.46 |
| Max. Negotiated Rate |
$6,698.02 |
| Rate for Payer: Aetna Commercial |
$6,325.91
|
| Rate for Payer: BCBS Trust/PPO |
$6,075.11
|
| Rate for Payer: BCN Commercial |
$5,751.37
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$6,400.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Healthscope Commercial |
$6,698.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,581.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,325.91
|
| Rate for Payer: Nomi Health Commercial |
$6,102.65
|
| Rate for Payer: PHP Commercial |
$6,325.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,837.46
|
| Rate for Payer: Priority Health HMO/PPO |
$6,474.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,986.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,549.18
|
| Rate for Payer: UHC Core |
$6,214.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,581.69
|
|
