|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$373.26 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: BCBS Trust/PPO |
$472.95
|
| Rate for Payer: BCN Commercial |
$472.95
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.25
|
| Rate for Payer: BCBS Complete |
$322.96
|
| Rate for Payer: BCBS MAPPO |
$153.00
|
| Rate for Payer: BCBS Trust/PPO |
$475.83
|
| Rate for Payer: BCN Commercial |
$475.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$307.58
|
| Rate for Payer: Meridian Medicaid |
$322.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PACE Senior Care Partners |
$145.35
|
| Rate for Payer: PACE SWMI |
$153.00
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$153.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.44
|
| Rate for Payer: Priority Health Medicare |
$153.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.26
|
| Rate for Payer: Railroad Medicare Medicare |
$153.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.00
|
| Rate for Payer: UHC Medicare Advantage |
$157.59
|
| Rate for Payer: VA VA |
$153.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$18.48
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$16.63 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna Medicare |
$4.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.78
|
| Rate for Payer: BCBS Complete |
$7.39
|
| Rate for Payer: BCBS MAPPO |
$4.62
|
| Rate for Payer: BCBS Trust/PPO |
$14.37
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Medicare Advantage |
$4.62
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$15.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.62
|
| Rate for Payer: Healthscope Commercial |
$16.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.71
|
| Rate for Payer: PACE Senior Care Partners |
$4.39
|
| Rate for Payer: PACE SWMI |
$4.62
|
| Rate for Payer: PHP Commercial |
$15.71
|
| Rate for Payer: PHP Medicare Advantage |
$4.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.08
|
| Rate for Payer: Priority Health Medicare |
$4.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.27
|
| Rate for Payer: Railroad Medicare Medicare |
$4.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.26
|
| Rate for Payer: UHC Core |
$15.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.62
|
| Rate for Payer: UHC Medicare Advantage |
$4.76
|
| Rate for Payer: VA VA |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.86
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$18.48
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$16.63 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$14.28
|
| Rate for Payer: BCN Commercial |
$14.28
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$15.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Healthscope Commercial |
$16.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.71
|
| Rate for Payer: PHP Commercial |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.26
|
| Rate for Payer: UHC Core |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.86
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: BCBS Trust/PPO |
$208.89
|
| Rate for Payer: BCN Commercial |
$208.89
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$225.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$70.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.47
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$67.58
|
| Rate for Payer: BCBS Trust/PPO |
$210.16
|
| Rate for Payer: BCN Commercial |
$210.16
|
| Rate for Payer: BCN Medicare Advantage |
$67.58
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.58
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PACE Senior Care Partners |
$64.20
|
| Rate for Payer: PACE SWMI |
$67.58
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: PHP Medicare Advantage |
$67.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.16
|
| Rate for Payer: Priority Health Medicare |
$67.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.86
|
| Rate for Payer: Railroad Medicare Medicare |
$67.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$225.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.58
|
| Rate for Payer: UHC Medicare Advantage |
$69.60
|
| Rate for Payer: VA VA |
$67.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$40.70
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: Aetna Medicare |
$10.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$31.64
|
| Rate for Payer: BCN Commercial |
$31.64
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Mclaren Medicaid |
$4.11
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.41
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$33.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.18
|
| Rate for Payer: UHC Medicare Advantage |
$10.48
|
| Rate for Payer: VA VA |
$10.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
IP
|
$40.70
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.82 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: BCBS Trust/PPO |
$31.45
|
| Rate for Payer: BCN Commercial |
$31.45
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$33.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$18,972.73
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,571.47 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,662.13
|
| Rate for Payer: BCN Commercial |
$14,662.13
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,506.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,571.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,696.00
|
| Rate for Payer: UHC Core |
$15,842.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$18,972.73
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,506.02 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna Medicare |
$4,932.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,928.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,928.98
|
| Rate for Payer: BCBS Complete |
$7,589.09
|
| Rate for Payer: BCBS MAPPO |
$4,743.18
|
| Rate for Payer: BCBS Trust/PPO |
$14,751.30
|
| Rate for Payer: BCN Commercial |
$14,751.30
|
| Rate for Payer: BCN Medicare Advantage |
$4,743.18
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,743.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,980.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,454.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PACE Senior Care Partners |
$4,506.02
|
| Rate for Payer: PACE SWMI |
$4,743.18
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: PHP Medicare Advantage |
$4,743.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,506.28
|
| Rate for Payer: Priority Health Medicare |
$4,743.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,571.47
|
| Rate for Payer: Railroad Medicare Medicare |
$4,743.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,696.00
|
| Rate for Payer: UHC Core |
$15,842.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,743.18
|
| Rate for Payer: UHC Medicare Advantage |
$4,885.48
|
| Rate for Payer: VA VA |
$4,743.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$18,972.73
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,506.02 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna Medicare |
$4,932.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,928.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,928.98
|
| Rate for Payer: BCBS Complete |
$7,589.09
|
| Rate for Payer: BCBS MAPPO |
$4,743.18
|
| Rate for Payer: BCBS Trust/PPO |
$14,751.30
|
| Rate for Payer: BCN Commercial |
$14,751.30
|
| Rate for Payer: BCN Medicare Advantage |
$4,743.18
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,743.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,980.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,454.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PACE Senior Care Partners |
$4,506.02
|
| Rate for Payer: PACE SWMI |
$4,743.18
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: PHP Medicare Advantage |
$4,743.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,506.28
|
| Rate for Payer: Priority Health Medicare |
$4,743.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,571.47
|
| Rate for Payer: Railroad Medicare Medicare |
$4,743.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,696.00
|
| Rate for Payer: UHC Core |
$15,842.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,743.18
|
| Rate for Payer: UHC Medicare Advantage |
$4,885.48
|
| Rate for Payer: VA VA |
$4,743.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$18,972.73
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,571.47 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,662.13
|
| Rate for Payer: BCN Commercial |
$14,662.13
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,506.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,571.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,696.00
|
| Rate for Payer: UHC Core |
$15,842.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$18,727.35
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,421.81 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: BCBS Trust/PPO |
$14,472.50
|
| Rate for Payer: BCN Commercial |
$14,472.50
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,292.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,421.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,480.07
|
| Rate for Payer: UHC Core |
$15,637.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$18,727.35
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,447.75 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna Medicare |
$4,869.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,852.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,852.30
|
| Rate for Payer: BCBS Complete |
$7,490.94
|
| Rate for Payer: BCBS MAPPO |
$4,681.84
|
| Rate for Payer: BCBS Trust/PPO |
$14,560.51
|
| Rate for Payer: BCN Commercial |
$14,560.51
|
| Rate for Payer: BCN Medicare Advantage |
$4,681.84
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,681.84
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,915.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,384.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PACE Senior Care Partners |
$4,447.75
|
| Rate for Payer: PACE SWMI |
$4,681.84
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: PHP Medicare Advantage |
$4,681.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,292.79
|
| Rate for Payer: Priority Health Medicare |
$4,681.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,421.81
|
| Rate for Payer: Railroad Medicare Medicare |
$4,681.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,480.07
|
| Rate for Payer: UHC Core |
$15,637.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,681.84
|
| Rate for Payer: UHC Medicare Advantage |
$4,822.29
|
| Rate for Payer: VA VA |
$4,681.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,435.13 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: BCBS Trust/PPO |
$22,091.93
|
| Rate for Payer: BCN Commercial |
$22,091.93
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,870.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,435.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,156.44
|
| Rate for Payer: UHC Core |
$23,870.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
OP
|
$28,586.86
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,789.38 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna Medicare |
$7,432.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,933.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,933.39
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$7,146.72
|
| Rate for Payer: BCBS Trust/PPO |
$22,226.28
|
| Rate for Payer: BCN Commercial |
$22,226.28
|
| Rate for Payer: BCN Medicare Advantage |
$7,146.72
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,146.72
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,504.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,218.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PACE Senior Care Partners |
$6,789.38
|
| Rate for Payer: PACE SWMI |
$7,146.72
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: PHP Medicare Advantage |
$7,146.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,870.57
|
| Rate for Payer: Priority Health Medicare |
$7,146.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,435.13
|
| Rate for Payer: Railroad Medicare Medicare |
$7,146.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,156.44
|
| Rate for Payer: UHC Core |
$23,870.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,146.72
|
| Rate for Payer: UHC Medicare Advantage |
$7,361.12
|
| Rate for Payer: VA VA |
$7,146.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
OP
|
$11,594.76
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,753.76 |
| Max. Negotiated Rate |
$12,078.04 |
| Rate for Payer: Aetna Commercial |
$9,855.55
|
| Rate for Payer: Aetna Medicare |
$3,014.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,623.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,623.36
|
| Rate for Payer: BCBS Complete |
$12,078.04
|
| Rate for Payer: BCBS MAPPO |
$2,898.69
|
| Rate for Payer: BCBS Trust/PPO |
$9,014.93
|
| Rate for Payer: BCN Commercial |
$9,014.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,898.69
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cofinity Commercial |
$9,971.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,275.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,898.69
|
| Rate for Payer: Healthscope Commercial |
$10,435.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,696.07
|
| Rate for Payer: Mclaren Medicaid |
$11,502.90
|
| Rate for Payer: Meridian Medicaid |
$12,078.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,043.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,333.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,855.55
|
| Rate for Payer: PACE Senior Care Partners |
$2,753.76
|
| Rate for Payer: PACE SWMI |
$2,898.69
|
| Rate for Payer: PHP Commercial |
$9,855.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,898.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,116.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,087.44
|
| Rate for Payer: Priority Health Medicare |
$2,898.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,071.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,898.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,203.39
|
| Rate for Payer: UHC Core |
$9,681.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,898.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,985.65
|
| Rate for Payer: VA VA |
$2,898.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,696.07
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
IP
|
$11,594.76
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,071.64 |
| Max. Negotiated Rate |
$10,435.28 |
| Rate for Payer: Aetna Commercial |
$9,855.55
|
| Rate for Payer: BCBS Trust/PPO |
$8,960.43
|
| Rate for Payer: BCN Commercial |
$8,960.43
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cofinity Commercial |
$9,971.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,275.81
|
| Rate for Payer: Healthscope Commercial |
$10,435.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,696.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,855.55
|
| Rate for Payer: PHP Commercial |
$9,855.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,116.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,087.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,071.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,203.39
|
| Rate for Payer: UHC Core |
$9,681.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,696.07
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$12,754.23
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,029.13 |
| Max. Negotiated Rate |
$11,478.81 |
| Rate for Payer: Aetna Commercial |
$10,841.10
|
| Rate for Payer: Aetna Medicare |
$3,316.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,985.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,985.70
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$3,188.56
|
| Rate for Payer: BCBS Trust/PPO |
$9,916.41
|
| Rate for Payer: BCN Commercial |
$9,916.41
|
| Rate for Payer: BCN Medicare Advantage |
$3,188.56
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cofinity Commercial |
$10,968.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,203.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,188.56
|
| Rate for Payer: Healthscope Commercial |
$11,478.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,565.67
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,347.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,666.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,841.10
|
| Rate for Payer: PACE Senior Care Partners |
$3,029.13
|
| Rate for Payer: PACE SWMI |
$3,188.56
|
| Rate for Payer: PHP Commercial |
$10,841.10
|
| Rate for Payer: PHP Medicare Advantage |
$3,188.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,927.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,096.18
|
| Rate for Payer: Priority Health Medicare |
$3,188.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,778.80
|
| Rate for Payer: Railroad Medicare Medicare |
$3,188.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,223.72
|
| Rate for Payer: UHC Core |
$10,649.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,188.56
|
| Rate for Payer: UHC Medicare Advantage |
$3,284.21
|
| Rate for Payer: VA VA |
$3,188.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,565.67
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$12,754.23
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,778.80 |
| Max. Negotiated Rate |
$11,478.81 |
| Rate for Payer: Aetna Commercial |
$10,841.10
|
| Rate for Payer: BCBS Trust/PPO |
$9,856.47
|
| Rate for Payer: BCN Commercial |
$9,856.47
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cofinity Commercial |
$10,968.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,203.38
|
| Rate for Payer: Healthscope Commercial |
$11,478.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,565.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,841.10
|
| Rate for Payer: PHP Commercial |
$10,841.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,927.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,096.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,778.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,223.72
|
| Rate for Payer: UHC Core |
$10,649.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,565.67
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
IP
|
$18,727.35
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,421.81 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: BCBS Trust/PPO |
$14,472.50
|
| Rate for Payer: BCN Commercial |
$14,472.50
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,292.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,421.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,480.07
|
| Rate for Payer: UHC Core |
$15,637.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
