|
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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,409.52
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| 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 |
$1,348.85
|
| 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 |
$1,348.85
|
|
|
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 |
$1,348.85
|
| 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 |
$1,348.85
|
|
|
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 |
$175.84 |
| 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 |
$184.65
|
| 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 |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.28
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| 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 |
$175.84
|
| 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 |
$175.84
|
| Rate for Payer: VA VA |
$543.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,629.36
|
|
|
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 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 |
$271.13
|
| 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 |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.65
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| 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 |
$258.20
|
| 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 |
$258.20
|
| 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
|
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 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 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 |
$1,179.37 |
| 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 |
$1,179.37
|
| 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 |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| 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 |
$1,123.14
|
| 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 |
$1,123.14
|
| 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 |
$1,179.37
|
| 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 |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.07
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| 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 |
$1,123.14
|
| 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 |
$1,123.14
|
| 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
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$902.90 |
| Max. Negotiated Rate |
$3,421.50 |
| 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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.94
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| Rate for Payer: VA VA |
$950.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$847.92 |
| Max. Negotiated Rate |
$3,213.15 |
| Rate for Payer: Aetna Commercial |
$3,034.64
|
| Rate for Payer: Aetna Medicare |
$928.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,115.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,115.68
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$892.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,935.04
|
| Rate for Payer: BCN Commercial |
$2,775.81
|
| Rate for Payer: BCN Medicare Advantage |
$892.54
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,070.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.54
|
| Rate for Payer: Healthscope Commercial |
$3,213.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.63
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.17
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: PACE Senior Care Partners |
$847.92
|
| Rate for Payer: PACE SWMI |
$892.54
|
| Rate for Payer: PHP Commercial |
$3,034.64
|
| Rate for Payer: PHP Medicare Advantage |
$892.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health HMO/PPO |
$3,106.05
|
| Rate for Payer: Priority Health Medicare |
$901.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,392.01
|
| Rate for Payer: Railroad Medicare Medicare |
$892.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.75
|
| Rate for Payer: UHC Core |
$2,981.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.54
|
| Rate for Payer: UHC Exchange |
$892.54
|
| Rate for Payer: UHC Medicare Advantage |
$892.54
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$892.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.63
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,320.61 |
| Max. Negotiated Rate |
$3,213.15 |
| Rate for Payer: Aetna Commercial |
$3,034.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,914.33
|
| Rate for Payer: BCN Commercial |
$2,759.03
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,070.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Healthscope Commercial |
$3,213.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: Nomi Health Commercial |
$2,927.54
|
| Rate for Payer: PHP Commercial |
$3,034.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health HMO/PPO |
$3,106.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,392.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.75
|
| Rate for Payer: UHC Core |
$2,981.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.63
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$785.43 |
| Max. Negotiated Rate |
$1,087.52 |
| Rate for Payer: Aetna Commercial |
$1,027.10
|
| Rate for Payer: BCBS Trust/PPO |
$986.38
|
| Rate for Payer: BCN Commercial |
$933.81
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$1,039.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Healthscope Commercial |
$1,087.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: Nomi Health Commercial |
$990.85
|
| Rate for Payer: PHP Commercial |
$1,027.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,051.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$809.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.35
|
| Rate for Payer: UHC Core |
$1,008.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.26
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.98 |
| Max. Negotiated Rate |
$1,087.52 |
| Rate for Payer: Aetna Commercial |
$1,027.10
|
| Rate for Payer: Aetna Medicare |
$314.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$377.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$377.61
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$302.09
|
| Rate for Payer: BCBS Trust/PPO |
$993.38
|
| Rate for Payer: BCN Commercial |
$939.49
|
| Rate for Payer: BCN Medicare Advantage |
$302.09
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$1,039.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.09
|
| Rate for Payer: Healthscope Commercial |
$1,087.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.26
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.19
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: Nomi Health Commercial |
$990.85
|
| Rate for Payer: PACE Senior Care Partners |
$286.98
|
| Rate for Payer: PACE SWMI |
$302.09
|
| Rate for Payer: PHP Commercial |
$1,027.10
|
| Rate for Payer: PHP Medicare Advantage |
$302.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,051.26
|
| Rate for Payer: Priority Health Medicare |
$305.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$809.59
|
| Rate for Payer: Railroad Medicare Medicare |
$302.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.35
|
| Rate for Payer: UHC Core |
$1,008.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.09
|
| Rate for Payer: UHC Exchange |
$302.09
|
| Rate for Payer: UHC Medicare Advantage |
$302.09
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$302.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.26
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.88 |
| Max. Negotiated Rate |
$145.22 |
| Rate for Payer: Aetna Commercial |
$137.16
|
| Rate for Payer: BCBS Trust/PPO |
$131.72
|
| Rate for Payer: BCN Commercial |
$124.70
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$138.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Healthscope Commercial |
$145.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: Nomi Health Commercial |
$132.32
|
| Rate for Payer: PHP Commercial |
$137.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: Priority Health HMO/PPO |
$140.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.00
|
| Rate for Payer: UHC Core |
$134.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.02
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.54 |
| Max. Negotiated Rate |
$145.22 |
| Rate for Payer: Aetna Commercial |
$137.16
|
| Rate for Payer: Aetna Medicare |
$41.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.42
|
| Rate for Payer: BCBS Complete |
$25.77
|
| Rate for Payer: BCBS MAPPO |
$40.34
|
| Rate for Payer: BCBS Trust/PPO |
$132.65
|
| Rate for Payer: BCN Commercial |
$125.46
|
| Rate for Payer: BCN Medicare Advantage |
$40.34
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$138.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.34
|
| Rate for Payer: Healthscope Commercial |
$145.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.02
|
| Rate for Payer: Mclaren Medicaid |
$24.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.36
|
| Rate for Payer: Meridian Medicaid |
$25.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: Nomi Health Commercial |
$132.32
|
| Rate for Payer: PACE Senior Care Partners |
$38.32
|
| Rate for Payer: PACE SWMI |
$40.34
|
| Rate for Payer: PHP Commercial |
$137.16
|
| Rate for Payer: PHP Medicare Advantage |
$40.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: Priority Health HMO/PPO |
$140.38
|
| Rate for Payer: Priority Health Medicare |
$40.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.11
|
| Rate for Payer: Railroad Medicare Medicare |
$40.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.00
|
| Rate for Payer: UHC Core |
$134.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.34
|
| Rate for Payer: UHC Exchange |
$40.34
|
| Rate for Payer: UHC Medicare Advantage |
$40.34
|
| Rate for Payer: UHCCP Medicaid |
$24.54
|
| Rate for Payer: VA VA |
$40.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.02
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$14.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.23
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.33
|
| Rate for Payer: BCN Commercial |
$42.87
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.47
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: PACE Senior Care Partners |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO |
$47.97
|
| Rate for Payer: Priority Health Medicare |
$13.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.52
|
| Rate for Payer: UHC Core |
$46.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.79
|
| Rate for Payer: UHC Exchange |
$13.79
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: VA VA |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
