|
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 |
$1,155.53
|
| 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 |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.73
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| 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 |
$1,100.43
|
| 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 |
$1,100.43
|
| Rate for Payer: VA VA |
$663.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,990.66
|
|
|
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 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 |
$13,357.09 |
| 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 |
$13,357.09
|
| 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 |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,221.53
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| 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 |
$12,720.20
|
| 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 |
$12,720.20
|
| Rate for Payer: VA VA |
$2,115.74
|
| 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
|
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 |
$6,102.64
|
| 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
|
|
|
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 |
$8,435.67 |
| 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 |
$8,435.67
|
| 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 |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,953.59
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| 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 |
$6,102.64
|
| 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 |
$8,033.44
|
| 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 |
$8,033.44
|
| 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 SUBSEQUENT DAY
|
Facility
|
OP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,275.28 |
| Max. Negotiated Rate |
$4,832.63 |
| Rate for Payer: Aetna Commercial |
$4,564.15
|
| Rate for Payer: Aetna Medicare |
$1,396.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,678.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,678.00
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,342.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,414.34
|
| Rate for Payer: BCN Commercial |
$4,174.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,342.40
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$4,617.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,342.40
|
| Rate for Payer: Healthscope Commercial |
$4,832.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,027.19
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,409.52
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,543.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,564.15
|
| Rate for Payer: Nomi Health Commercial |
$4,403.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,275.28
|
| Rate for Payer: PACE SWMI |
$1,342.40
|
| Rate for Payer: PHP Commercial |
$4,564.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,342.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,490.23
|
| Rate for Payer: Priority Health HMO/PPO |
$4,671.54
|
| Rate for Payer: Priority Health Medicare |
$1,355.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,597.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,342.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,725.24
|
| Rate for Payer: UHC Core |
$4,483.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,342.40
|
| Rate for Payer: UHC Exchange |
$1,342.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,342.40
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,342.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,027.19
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,490.23 |
| Max. Negotiated Rate |
$4,832.63 |
| Rate for Payer: Aetna Commercial |
$4,564.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,383.20
|
| Rate for Payer: BCN Commercial |
$4,149.62
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$4,617.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Healthscope Commercial |
$4,832.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,027.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,564.15
|
| Rate for Payer: Nomi Health Commercial |
$4,403.06
|
| Rate for Payer: PHP Commercial |
$4,564.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,490.23
|
| Rate for Payer: Priority Health HMO/PPO |
$4,671.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,597.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,725.24
|
| Rate for Payer: UHC Core |
$4,483.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,027.19
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$427.13 |
| Max. Negotiated Rate |
$1,618.61 |
| Rate for Payer: Aetna Commercial |
$1,528.69
|
| Rate for Payer: Aetna Medicare |
$467.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$562.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$562.02
|
| Rate for Payer: BCBS Complete |
$719.38
|
| Rate for Payer: BCBS MAPPO |
$449.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.51
|
| Rate for Payer: BCN Commercial |
$1,398.30
|
| Rate for Payer: BCN Medicare Advantage |
$449.62
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,546.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.62
|
| Rate for Payer: Healthscope Commercial |
$1,618.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,348.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$517.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: Nomi Health Commercial |
$1,474.74
|
| Rate for Payer: PACE Senior Care Partners |
$427.13
|
| Rate for Payer: PACE SWMI |
$449.62
|
| Rate for Payer: PHP Commercial |
$1,528.69
|
| Rate for Payer: PHP Medicare Advantage |
$449.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,564.66
|
| Rate for Payer: Priority Health Medicare |
$454.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,204.97
|
| Rate for Payer: Railroad Medicare Medicare |
$449.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,582.64
|
| Rate for Payer: UHC Core |
$1,501.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.62
|
| Rate for Payer: UHC Exchange |
$449.62
|
| Rate for Payer: UHC Medicare Advantage |
$449.62
|
| Rate for Payer: VA VA |
$449.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,348.84
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,169.00 |
| Max. Negotiated Rate |
$1,618.61 |
| Rate for Payer: Aetna Commercial |
$1,528.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.08
|
| Rate for Payer: BCN Commercial |
$1,389.85
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,546.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Healthscope Commercial |
$1,618.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,348.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: Nomi Health Commercial |
$1,474.74
|
| Rate for Payer: PHP Commercial |
$1,528.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,564.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,204.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,582.64
|
| Rate for Payer: UHC Core |
$1,501.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,348.84
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,412.11 |
| Max. Negotiated Rate |
$1,955.23 |
| Rate for Payer: Aetna Commercial |
$1,846.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.40
|
| Rate for Payer: BCN Commercial |
$1,678.89
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$1,868.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Healthscope Commercial |
$1,955.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,629.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,846.61
|
| Rate for Payer: Nomi Health Commercial |
$1,781.43
|
| Rate for Payer: PHP Commercial |
$1,846.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,412.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,890.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,455.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,911.78
|
| Rate for Payer: UHC Core |
$1,814.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,629.36
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$172.28 |
| Max. Negotiated Rate |
$1,955.23 |
| Rate for Payer: Aetna Commercial |
$1,846.61
|
| Rate for Payer: Aetna Medicare |
$564.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$678.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$678.90
|
| Rate for Payer: BCBS Complete |
$180.91
|
| Rate for Payer: BCBS MAPPO |
$543.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,786.00
|
| Rate for Payer: BCN Commercial |
$1,689.10
|
| Rate for Payer: BCN Medicare Advantage |
$543.12
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$1,868.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.12
|
| Rate for Payer: Healthscope Commercial |
$1,955.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,629.36
|
| Rate for Payer: Mclaren Medicaid |
$172.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.28
|
| Rate for Payer: Meridian Medicaid |
$180.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$624.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,846.61
|
| Rate for Payer: Nomi Health Commercial |
$1,781.43
|
| Rate for Payer: PACE Senior Care Partners |
$515.96
|
| Rate for Payer: PACE SWMI |
$543.12
|
| Rate for Payer: PHP Commercial |
$1,846.61
|
| Rate for Payer: PHP Medicare Advantage |
$543.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,412.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,890.06
|
| Rate for Payer: Priority Health Medicare |
$548.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,455.56
|
| Rate for Payer: Railroad Medicare Medicare |
$543.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,911.78
|
| Rate for Payer: UHC Core |
$1,814.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.12
|
| Rate for Payer: UHC Exchange |
$543.12
|
| Rate for Payer: UHC Medicare Advantage |
$543.12
|
| Rate for Payer: UHCCP Medicaid |
$172.28
|
| Rate for Payer: VA VA |
$543.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,629.36
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$110.06 |
| Max. Negotiated Rate |
$417.09 |
| Rate for Payer: Aetna Commercial |
$393.92
|
| Rate for Payer: Aetna Medicare |
$120.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.82
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$380.99
|
| Rate for Payer: BCN Commercial |
$360.32
|
| Rate for Payer: BCN Medicare Advantage |
$115.86
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$398.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| Rate for Payer: Healthscope Commercial |
$417.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.57
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: Nomi Health Commercial |
$380.01
|
| Rate for Payer: PACE Senior Care Partners |
$110.06
|
| Rate for Payer: PACE SWMI |
$115.86
|
| Rate for Payer: PHP Commercial |
$393.92
|
| Rate for Payer: PHP Medicare Advantage |
$115.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health HMO/PPO |
$403.18
|
| Rate for Payer: Priority Health Medicare |
$117.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.50
|
| Rate for Payer: Railroad Medicare Medicare |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.82
|
| Rate for Payer: UHC Core |
$386.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Exchange |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$115.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.57
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$301.23 |
| Max. Negotiated Rate |
$417.09 |
| Rate for Payer: Aetna Commercial |
$393.92
|
| Rate for Payer: BCBS Trust/PPO |
$378.30
|
| Rate for Payer: BCN Commercial |
$358.14
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$398.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Healthscope Commercial |
$417.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: Nomi Health Commercial |
$380.01
|
| Rate for Payer: PHP Commercial |
$393.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health HMO/PPO |
$403.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.82
|
| Rate for Payer: UHC Core |
$386.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.57
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$84.88 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$92.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.68
|
| Rate for Payer: BCBS Complete |
$142.95
|
| Rate for Payer: BCBS MAPPO |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.80
|
| Rate for Payer: BCN Commercial |
$277.86
|
| Rate for Payer: BCN Medicare Advantage |
$89.34
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.34
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$84.88
|
| Rate for Payer: PACE SWMI |
$89.34
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Medicare |
$90.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: Railroad Medicare Medicare |
$89.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.34
|
| Rate for Payer: UHC Exchange |
$89.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.34
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: BCBS Trust/PPO |
$291.73
|
| Rate for Payer: BCN Commercial |
$276.18
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.76 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: BCBS Trust/PPO |
$400.31
|
| Rate for Payer: BCN Commercial |
$378.98
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO |
$426.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.55
|
| Rate for Payer: UHC Core |
$409.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.47 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.25
|
| Rate for Payer: BCBS Complete |
$196.16
|
| Rate for Payer: BCBS MAPPO |
$122.60
|
| Rate for Payer: BCBS Trust/PPO |
$403.16
|
| Rate for Payer: BCN Commercial |
$381.29
|
| Rate for Payer: BCN Medicare Advantage |
$122.60
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.60
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$402.13
|
| Rate for Payer: PACE Senior Care Partners |
$116.47
|
| Rate for Payer: PACE SWMI |
$122.60
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: PHP Medicare Advantage |
$122.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO |
$426.65
|
| Rate for Payer: Priority Health Medicare |
$123.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.57
|
| Rate for Payer: Railroad Medicare Medicare |
$122.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.55
|
| Rate for Payer: UHC Core |
$409.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.60
|
| Rate for Payer: UHC Exchange |
$122.60
|
| Rate for Payer: UHC Medicare Advantage |
$122.60
|
| Rate for Payer: VA VA |
$122.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: BCBS Trust/PPO |
$916.45
|
| Rate for Payer: BCN Commercial |
$867.61
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO |
$976.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.97
|
| Rate for Payer: UHC Core |
$937.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$266.64 |
| Max. Negotiated Rate |
$1,155.53 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna Medicare |
$291.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.84
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$280.67
|
| Rate for Payer: BCBS Trust/PPO |
$922.96
|
| Rate for Payer: BCN Commercial |
$872.89
|
| Rate for Payer: BCN Medicare Advantage |
$280.67
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.67
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PACE Senior Care Partners |
$266.64
|
| Rate for Payer: PACE SWMI |
$280.67
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: PHP Medicare Advantage |
$280.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO |
$976.74
|
| Rate for Payer: Priority Health Medicare |
$283.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.20
|
| Rate for Payer: Railroad Medicare Medicare |
$280.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.97
|
| Rate for Payer: UHC Core |
$937.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.67
|
| Rate for Payer: UHC Exchange |
$280.67
|
| Rate for Payer: UHC Medicare Advantage |
$280.67
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$280.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$339.35 |
| Max. Negotiated Rate |
$1,285.96 |
| Rate for Payer: Aetna Commercial |
$1,214.52
|
| Rate for Payer: Aetna Medicare |
$371.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.52
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$357.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.66
|
| Rate for Payer: BCN Commercial |
$1,110.93
|
| Rate for Payer: BCN Medicare Advantage |
$357.21
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,228.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.21
|
| Rate for Payer: Healthscope Commercial |
$1,285.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.64
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.07
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: PACE Senior Care Partners |
$339.35
|
| Rate for Payer: PACE SWMI |
$357.21
|
| Rate for Payer: PHP Commercial |
$1,214.52
|
| Rate for Payer: PHP Medicare Advantage |
$357.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,243.10
|
| Rate for Payer: Priority Health Medicare |
$360.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.33
|
| Rate for Payer: Railroad Medicare Medicare |
$357.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.39
|
| Rate for Payer: UHC Core |
$1,193.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$357.21
|
| Rate for Payer: UHC Exchange |
$357.21
|
| Rate for Payer: UHC Medicare Advantage |
$357.21
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$357.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.64
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$928.75 |
| Max. Negotiated Rate |
$1,285.96 |
| Rate for Payer: Aetna Commercial |
$1,214.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.37
|
| Rate for Payer: BCN Commercial |
$1,104.22
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,228.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Healthscope Commercial |
$1,285.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: Nomi Health Commercial |
$1,171.66
|
| Rate for Payer: PHP Commercial |
$1,214.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,243.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,257.39
|
| Rate for Payer: UHC Core |
$1,193.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.64
|
|
