|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$18,727.35
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
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 DES/CABG INITIAL
|
Facility
|
OP
|
$28,586.86
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 MI/DES
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,742.92 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: BCBS Trust/PPO |
$22,481.93
|
| Rate for Payer: BCN Commercial |
$22,481.93
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,909.24 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna Medicare |
$7,563.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,091.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,091.10
|
| Rate for Payer: BCBS Complete |
$11,636.61
|
| Rate for Payer: BCBS MAPPO |
$7,272.88
|
| Rate for Payer: BCBS Trust/PPO |
$22,618.66
|
| Rate for Payer: BCN Commercial |
$22,618.66
|
| Rate for Payer: BCN Medicare Advantage |
$7,272.88
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,272.88
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,636.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,363.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PACE Senior Care Partners |
$6,909.24
|
| Rate for Payer: PACE SWMI |
$7,272.88
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: PHP Medicare Advantage |
$7,272.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Medicare |
$7,272.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,272.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,272.88
|
| Rate for Payer: UHC Medicare Advantage |
$7,491.07
|
| Rate for Payer: VA VA |
$7,272.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,742.92 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: BCBS Trust/PPO |
$22,481.93
|
| Rate for Payer: BCN Commercial |
$22,481.93
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,909.24 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna Medicare |
$7,563.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,091.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,091.10
|
| Rate for Payer: BCBS Complete |
$11,636.61
|
| Rate for Payer: BCBS MAPPO |
$7,272.88
|
| Rate for Payer: BCBS Trust/PPO |
$22,618.66
|
| Rate for Payer: BCN Commercial |
$22,618.66
|
| Rate for Payer: BCN Medicare Advantage |
$7,272.88
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,272.88
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,636.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,363.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PACE Senior Care Partners |
$6,909.24
|
| Rate for Payer: PACE SWMI |
$7,272.88
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: PHP Medicare Advantage |
$7,272.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Medicare |
$7,272.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,272.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,272.88
|
| Rate for Payer: UHC Medicare Advantage |
$7,491.07
|
| Rate for Payer: VA VA |
$7,272.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$15,710.04
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,581.55 |
| Max. Negotiated Rate |
$14,139.04 |
| Rate for Payer: Aetna Commercial |
$13,353.53
|
| Rate for Payer: BCBS Trust/PPO |
$12,140.72
|
| Rate for Payer: BCN Commercial |
$12,140.72
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cofinity Commercial |
$13,510.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,568.03
|
| Rate for Payer: Healthscope Commercial |
$14,139.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,782.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,353.53
|
| Rate for Payer: PHP Commercial |
$13,353.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,997.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,667.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,581.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,824.84
|
| Rate for Payer: UHC Core |
$13,117.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,782.53
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$15,710.04
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,731.13 |
| Max. Negotiated Rate |
$14,139.04 |
| Rate for Payer: Aetna Commercial |
$13,353.53
|
| Rate for Payer: Aetna Medicare |
$4,084.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,909.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,909.39
|
| Rate for Payer: BCBS Complete |
$4,710.75
|
| Rate for Payer: BCBS MAPPO |
$3,927.51
|
| Rate for Payer: BCBS Trust/PPO |
$12,214.56
|
| Rate for Payer: BCN Commercial |
$12,214.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,927.51
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cofinity Commercial |
$13,510.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,568.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,927.51
|
| Rate for Payer: Healthscope Commercial |
$14,139.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,782.53
|
| Rate for Payer: Mclaren Medicaid |
$4,486.43
|
| Rate for Payer: Meridian Medicaid |
$4,710.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,123.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,516.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,353.53
|
| Rate for Payer: PACE Senior Care Partners |
$3,731.13
|
| Rate for Payer: PACE SWMI |
$3,927.51
|
| Rate for Payer: PHP Commercial |
$13,353.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,927.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,486.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,997.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,667.73
|
| Rate for Payer: Priority Health Medicare |
$3,927.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,581.55
|
| Rate for Payer: Railroad Medicare Medicare |
$3,927.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,824.84
|
| Rate for Payer: UHC Core |
$13,117.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,927.51
|
| Rate for Payer: UHC Medicare Advantage |
$4,045.34
|
| Rate for Payer: VA VA |
$3,927.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,782.53
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,263.14
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,429.79 |
| Max. Negotiated Rate |
$6,536.83 |
| Rate for Payer: Aetna Commercial |
$6,173.67
|
| Rate for Payer: BCBS Trust/PPO |
$5,612.95
|
| Rate for Payer: BCN Commercial |
$5,612.95
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cofinity Commercial |
$6,246.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,810.51
|
| Rate for Payer: Healthscope Commercial |
$6,536.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,447.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,173.67
|
| Rate for Payer: PHP Commercial |
$6,173.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,084.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,318.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,429.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,391.56
|
| Rate for Payer: UHC Core |
$6,064.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,447.36
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,263.14
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,725.00 |
| Max. Negotiated Rate |
$6,536.83 |
| Rate for Payer: Aetna Commercial |
$6,173.67
|
| Rate for Payer: Aetna Medicare |
$1,888.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,269.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,269.73
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,815.78
|
| Rate for Payer: BCBS Trust/PPO |
$5,647.09
|
| Rate for Payer: BCN Commercial |
$5,647.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,815.78
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cofinity Commercial |
$6,246.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,810.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,815.78
|
| Rate for Payer: Healthscope Commercial |
$6,536.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,447.36
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,906.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,088.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,173.67
|
| Rate for Payer: PACE Senior Care Partners |
$1,725.00
|
| Rate for Payer: PACE SWMI |
$1,815.78
|
| Rate for Payer: PHP Commercial |
$6,173.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,815.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,084.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,318.93
|
| Rate for Payer: Priority Health Medicare |
$1,815.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,429.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,815.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,391.56
|
| Rate for Payer: UHC Core |
$6,064.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,815.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,870.26
|
| Rate for Payer: VA VA |
$1,815.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,447.36
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$5,770.46
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,370.48 |
| Max. Negotiated Rate |
$5,193.41 |
| Rate for Payer: Aetna Commercial |
$4,904.89
|
| Rate for Payer: Aetna Medicare |
$1,500.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.27
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,442.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,486.53
|
| Rate for Payer: BCN Commercial |
$4,486.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.62
|
| Rate for Payer: Cash Price |
$4,616.37
|
| Rate for Payer: Cash Price |
$4,616.37
|
| Rate for Payer: Cofinity Commercial |
$4,962.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,616.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.62
|
| Rate for Payer: Healthscope Commercial |
$5,193.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,327.84
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,904.89
|
| Rate for Payer: PACE Senior Care Partners |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.62
|
| Rate for Payer: PHP Commercial |
$4,904.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,039.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,020.30
|
| Rate for Payer: Priority Health Medicare |
$1,442.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,519.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,078.00
|
| Rate for Payer: UHC Core |
$4,818.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,327.84
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$5,770.46
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,519.40 |
| Max. Negotiated Rate |
$5,193.41 |
| Rate for Payer: Aetna Commercial |
$4,904.89
|
| Rate for Payer: BCBS Trust/PPO |
$4,459.41
|
| Rate for Payer: BCN Commercial |
$4,459.41
|
| Rate for Payer: Cash Price |
$4,616.37
|
| Rate for Payer: Cofinity Commercial |
$4,962.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,616.37
|
| Rate for Payer: Healthscope Commercial |
$5,193.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,327.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,904.89
|
| Rate for Payer: PHP Commercial |
$4,904.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,039.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,020.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,519.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,078.00
|
| Rate for Payer: UHC Core |
$4,818.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,327.84
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.77 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna Medicare |
$683.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.07
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$657.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.30
|
| Rate for Payer: BCN Commercial |
$2,045.30
|
| Rate for Payer: BCN Medicare Advantage |
$657.65
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.65
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$690.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PACE Senior Care Partners |
$624.77
|
| Rate for Payer: PACE SWMI |
$657.65
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: PHP Medicare Advantage |
$657.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Medicare |
$657.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: Railroad Medicare Medicare |
$657.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.65
|
| Rate for Payer: UHC Medicare Advantage |
$677.38
|
| Rate for Payer: VA VA |
$657.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,604.41 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.94
|
| Rate for Payer: BCN Commercial |
$2,032.94
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,753.45
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$416.44 |
| Max. Negotiated Rate |
$1,578.10 |
| Rate for Payer: Aetna Commercial |
$1,490.43
|
| Rate for Payer: Aetna Medicare |
$455.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$547.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$547.95
|
| Rate for Payer: BCBS Complete |
$701.38
|
| Rate for Payer: BCBS MAPPO |
$438.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.31
|
| Rate for Payer: BCN Commercial |
$1,363.31
|
| Rate for Payer: BCN Medicare Advantage |
$438.36
|
| Rate for Payer: Cash Price |
$1,402.76
|
| Rate for Payer: Cofinity Commercial |
$1,507.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$438.36
|
| Rate for Payer: Healthscope Commercial |
$1,578.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,315.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$460.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$504.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,490.43
|
| Rate for Payer: PACE Senior Care Partners |
$416.44
|
| Rate for Payer: PACE SWMI |
$438.36
|
| Rate for Payer: PHP Commercial |
$1,490.43
|
| Rate for Payer: PHP Medicare Advantage |
$438.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.50
|
| Rate for Payer: Priority Health Medicare |
$438.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.43
|
| Rate for Payer: Railroad Medicare Medicare |
$438.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.04
|
| Rate for Payer: UHC Core |
$1,464.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$438.36
|
| Rate for Payer: UHC Medicare Advantage |
$451.51
|
| Rate for Payer: VA VA |
$438.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,315.09
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,753.45
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,069.43 |
| Max. Negotiated Rate |
$1,578.10 |
| Rate for Payer: Aetna Commercial |
$1,490.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,355.07
|
| Rate for Payer: BCN Commercial |
$1,355.07
|
| Rate for Payer: Cash Price |
$1,402.76
|
| Rate for Payer: Cofinity Commercial |
$1,507.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,402.76
|
| Rate for Payer: Healthscope Commercial |
$1,578.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,315.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,490.43
|
| Rate for Payer: PHP Commercial |
$1,490.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,525.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,543.04
|
| Rate for Payer: UHC Core |
$1,464.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,315.09
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$278.41
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.12 |
| Max. Negotiated Rate |
$250.57 |
| Rate for Payer: Aetna Commercial |
$236.65
|
| Rate for Payer: Aetna Medicare |
$72.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.00
|
| Rate for Payer: BCBS Complete |
$111.36
|
| Rate for Payer: BCBS MAPPO |
$69.60
|
| Rate for Payer: BCBS Trust/PPO |
$216.46
|
| Rate for Payer: BCN Commercial |
$216.46
|
| Rate for Payer: BCN Medicare Advantage |
$69.60
|
| Rate for Payer: Cash Price |
$222.73
|
| Rate for Payer: Cofinity Commercial |
$239.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.60
|
| Rate for Payer: Healthscope Commercial |
$250.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.65
|
| Rate for Payer: PACE Senior Care Partners |
$66.12
|
| Rate for Payer: PACE SWMI |
$69.60
|
| Rate for Payer: PHP Commercial |
$236.65
|
| Rate for Payer: PHP Medicare Advantage |
$69.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.22
|
| Rate for Payer: Priority Health Medicare |
$69.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.80
|
| Rate for Payer: Railroad Medicare Medicare |
$69.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.00
|
| Rate for Payer: UHC Core |
$232.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.60
|
| Rate for Payer: UHC Medicare Advantage |
$71.69
|
| Rate for Payer: VA VA |
$69.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.81
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$278.41
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$169.80 |
| Max. Negotiated Rate |
$250.57 |
| Rate for Payer: Aetna Commercial |
$236.65
|
| Rate for Payer: BCBS Trust/PPO |
$215.16
|
| Rate for Payer: BCN Commercial |
$215.16
|
| Rate for Payer: Cash Price |
$222.73
|
| Rate for Payer: Cofinity Commercial |
$239.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.73
|
| Rate for Payer: Healthscope Commercial |
$250.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.65
|
| Rate for Payer: PHP Commercial |
$236.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.00
|
| Rate for Payer: UHC Core |
$232.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.81
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
IP
|
$3,693.37
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,252.59 |
| Max. Negotiated Rate |
$3,324.03 |
| Rate for Payer: Aetna Commercial |
$3,139.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,854.24
|
| Rate for Payer: BCN Commercial |
$2,854.24
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cofinity Commercial |
$3,176.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
| Rate for Payer: Healthscope Commercial |
$3,324.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
| Rate for Payer: PHP Commercial |
$3,139.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,213.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,252.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.17
|
| Rate for Payer: UHC Core |
$3,083.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
OP
|
$3,693.37
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$780.72 |
| Max. Negotiated Rate |
$3,324.03 |
| Rate for Payer: Aetna Commercial |
$3,139.36
|
| Rate for Payer: Aetna Medicare |
$960.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,154.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,154.18
|
| Rate for Payer: BCBS Complete |
$819.75
|
| Rate for Payer: BCBS MAPPO |
$923.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,871.60
|
| Rate for Payer: BCN Commercial |
$2,871.60
|
| Rate for Payer: BCN Medicare Advantage |
$923.34
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cofinity Commercial |
$3,176.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.34
|
| Rate for Payer: Healthscope Commercial |
$3,324.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
| Rate for Payer: Mclaren Medicaid |
$780.72
|
| Rate for Payer: Meridian Medicaid |
$819.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$969.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
| Rate for Payer: PACE Senior Care Partners |
$877.18
|
| Rate for Payer: PACE SWMI |
$923.34
|
| Rate for Payer: PHP Commercial |
$3,139.36
|
| Rate for Payer: PHP Medicare Advantage |
$923.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$780.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,213.23
|
| Rate for Payer: Priority Health Medicare |
$923.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,252.59
|
| Rate for Payer: Railroad Medicare Medicare |
$923.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.17
|
| Rate for Payer: UHC Core |
$3,083.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.34
|
| Rate for Payer: UHC Medicare Advantage |
$951.04
|
| Rate for Payer: VA VA |
$923.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
