|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.82
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,869.66
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,970.01 |
| Max. Negotiated Rate |
$4,382.69 |
| Rate for Payer: Aetna Commercial |
$4,139.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,763.27
|
| Rate for Payer: BCN Commercial |
$3,763.27
|
| Rate for Payer: Cash Price |
$3,895.73
|
| Rate for Payer: Cofinity Commercial |
$4,187.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,895.73
|
| Rate for Payer: Healthscope Commercial |
$4,382.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,652.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,139.21
|
| Rate for Payer: PHP Commercial |
$4,139.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,408.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,236.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,285.30
|
| Rate for Payer: UHC Core |
$4,066.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,652.24
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,869.66
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,156.54 |
| Max. Negotiated Rate |
$4,382.69 |
| Rate for Payer: Aetna Commercial |
$4,139.21
|
| Rate for Payer: Aetna Medicare |
$1,266.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,521.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,521.77
|
| Rate for Payer: BCBS Complete |
$1,947.86
|
| Rate for Payer: BCBS MAPPO |
$1,217.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,786.16
|
| Rate for Payer: BCN Commercial |
$3,786.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,217.42
|
| Rate for Payer: Cash Price |
$3,895.73
|
| Rate for Payer: Cofinity Commercial |
$4,187.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,895.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,217.42
|
| Rate for Payer: Healthscope Commercial |
$4,382.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,652.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,278.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,400.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,139.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,156.54
|
| Rate for Payer: PACE SWMI |
$1,217.42
|
| Rate for Payer: PHP Commercial |
$4,139.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,217.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,408.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,236.60
|
| Rate for Payer: Priority Health Medicare |
$1,217.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,217.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,285.30
|
| Rate for Payer: UHC Core |
$4,066.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,217.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,253.94
|
| Rate for Payer: VA VA |
$1,217.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,652.24
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,633.63
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,435.95 |
| Max. Negotiated Rate |
$5,070.27 |
| Rate for Payer: Aetna Commercial |
$4,788.59
|
| Rate for Payer: BCBS Trust/PPO |
$4,353.67
|
| Rate for Payer: BCN Commercial |
$4,353.67
|
| Rate for Payer: Cash Price |
$4,506.90
|
| Rate for Payer: Cofinity Commercial |
$4,844.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,506.90
|
| Rate for Payer: Healthscope Commercial |
$5,070.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,225.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,788.59
|
| Rate for Payer: PHP Commercial |
$4,788.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,901.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,435.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,957.59
|
| Rate for Payer: UHC Core |
$4,704.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,225.22
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,633.63
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,337.99 |
| Max. Negotiated Rate |
$5,070.27 |
| Rate for Payer: Aetna Commercial |
$4,788.59
|
| Rate for Payer: Aetna Medicare |
$1,464.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,760.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,760.51
|
| Rate for Payer: BCBS Complete |
$2,253.45
|
| Rate for Payer: BCBS MAPPO |
$1,408.41
|
| Rate for Payer: BCBS Trust/PPO |
$4,380.15
|
| Rate for Payer: BCN Commercial |
$4,380.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,408.41
|
| Rate for Payer: Cash Price |
$4,506.90
|
| Rate for Payer: Cofinity Commercial |
$4,844.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,506.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,408.41
|
| Rate for Payer: Healthscope Commercial |
$5,070.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,225.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,478.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,619.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,788.59
|
| Rate for Payer: PACE Senior Care Partners |
$1,337.99
|
| Rate for Payer: PACE SWMI |
$1,408.41
|
| Rate for Payer: PHP Commercial |
$4,788.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,408.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,901.26
|
| Rate for Payer: Priority Health Medicare |
$1,408.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,435.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,408.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,957.59
|
| Rate for Payer: UHC Core |
$4,704.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,408.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,450.66
|
| Rate for Payer: VA VA |
$1,408.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,225.22
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,359.88
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,708.59 |
| Max. Negotiated Rate |
$8,423.89 |
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: BCBS Trust/PPO |
$7,233.32
|
| Rate for Payer: BCN Commercial |
$7,233.32
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,143.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,708.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,236.69
|
| Rate for Payer: UHC Core |
$7,815.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,359.88
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,090.97 |
| Max. Negotiated Rate |
$8,423.89 |
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: Aetna Medicare |
$2,433.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,924.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,924.96
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$2,339.97
|
| Rate for Payer: BCBS Trust/PPO |
$7,277.31
|
| Rate for Payer: BCN Commercial |
$7,277.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,339.97
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,339.97
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,456.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,690.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PACE Senior Care Partners |
$2,222.97
|
| Rate for Payer: PACE SWMI |
$2,339.97
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,339.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,143.10
|
| Rate for Payer: Priority Health Medicare |
$2,339.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,708.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,339.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,236.69
|
| Rate for Payer: UHC Core |
$7,815.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,339.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,410.17
|
| Rate for Payer: VA VA |
$2,339.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$10,751.21
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,553.41 |
| Max. Negotiated Rate |
$9,676.09 |
| Rate for Payer: Aetna Commercial |
$9,138.53
|
| Rate for Payer: Aetna Medicare |
$2,795.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,359.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,359.75
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$2,687.80
|
| Rate for Payer: BCBS Trust/PPO |
$8,359.07
|
| Rate for Payer: BCN Commercial |
$8,359.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,687.80
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cofinity Commercial |
$9,246.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,600.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,687.80
|
| Rate for Payer: Healthscope Commercial |
$9,676.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,063.41
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,822.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,090.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,138.53
|
| Rate for Payer: PACE Senior Care Partners |
$2,553.41
|
| Rate for Payer: PACE SWMI |
$2,687.80
|
| Rate for Payer: PHP Commercial |
$9,138.53
|
| Rate for Payer: PHP Medicare Advantage |
$2,687.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,353.55
|
| Rate for Payer: Priority Health Medicare |
$2,687.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,557.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,687.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,461.06
|
| Rate for Payer: UHC Core |
$8,977.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,687.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,768.44
|
| Rate for Payer: VA VA |
$2,687.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,063.41
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$10,751.21
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,557.16 |
| Max. Negotiated Rate |
$9,676.09 |
| Rate for Payer: Aetna Commercial |
$9,138.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,308.54
|
| Rate for Payer: BCN Commercial |
$8,308.54
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cofinity Commercial |
$9,246.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,600.97
|
| Rate for Payer: Healthscope Commercial |
$9,676.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,063.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,138.53
|
| Rate for Payer: PHP Commercial |
$9,138.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,353.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,557.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,461.06
|
| Rate for Payer: UHC Core |
$8,977.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,063.41
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$12,648.49
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,714.31 |
| Max. Negotiated Rate |
$11,383.64 |
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: BCBS Trust/PPO |
$9,774.75
|
| Rate for Payer: BCN Commercial |
$9,774.75
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,004.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,714.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,130.67
|
| Rate for Payer: UHC Core |
$10,561.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$12,648.49
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,004.02 |
| Max. Negotiated Rate |
$11,383.64 |
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: Aetna Medicare |
$3,288.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,952.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,952.65
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$3,162.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,834.20
|
| Rate for Payer: BCN Commercial |
$9,834.20
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.12
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.12
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,320.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,636.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PACE Senior Care Partners |
$3,004.02
|
| Rate for Payer: PACE SWMI |
$3,162.12
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,004.19
|
| Rate for Payer: Priority Health Medicare |
$3,162.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,714.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,130.67
|
| Rate for Payer: UHC Core |
$10,561.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,256.99
|
| Rate for Payer: VA VA |
$3,162.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$12,648.49
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,004.02 |
| Max. Negotiated Rate |
$11,383.64 |
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: Aetna Medicare |
$3,288.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,952.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,952.65
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$3,162.12
|
| Rate for Payer: BCBS Trust/PPO |
$9,834.20
|
| Rate for Payer: BCN Commercial |
$9,834.20
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.12
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.12
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,320.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,636.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PACE Senior Care Partners |
$3,004.02
|
| Rate for Payer: PACE SWMI |
$3,162.12
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,004.19
|
| Rate for Payer: Priority Health Medicare |
$3,162.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,714.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,130.67
|
| Rate for Payer: UHC Core |
$10,561.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.12
|
| Rate for Payer: UHC Medicare Advantage |
$3,256.99
|
| Rate for Payer: VA VA |
$3,162.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$12,648.49
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,714.31 |
| Max. Negotiated Rate |
$11,383.64 |
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: BCBS Trust/PPO |
$9,774.75
|
| Rate for Payer: BCN Commercial |
$9,774.75
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,004.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,714.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,130.67
|
| Rate for Payer: UHC Core |
$10,561.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
IP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.49 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.19
|
| Rate for Payer: BCN Commercial |
$1,303.19
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
OP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.50 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$438.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$526.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$526.98
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: BCBS MAPPO |
$421.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.11
|
| Rate for Payer: BCN Commercial |
$1,311.11
|
| Rate for Payer: BCN Medicare Advantage |
$421.58
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.58
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$442.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PACE Senior Care Partners |
$400.50
|
| Rate for Payer: PACE SWMI |
$421.58
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: PHP Medicare Advantage |
$421.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Medicare |
$421.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.49
|
| Rate for Payer: Railroad Medicare Medicare |
$421.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.58
|
| Rate for Payer: UHC Medicare Advantage |
$434.23
|
| Rate for Payer: VA VA |
$421.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELENIUM LEVEL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.78
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.84
|
| Rate for Payer: Meridian Medicaid |
$19.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC SELENIUM LEVEL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
IP
|
$0.51
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Aetna Commercial |
$0.43
|
| Rate for Payer: BCBS Trust/PPO |
$0.39
|
| Rate for Payer: BCN Commercial |
$0.39
|
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: Cofinity Commercial |
$0.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.41
|
| Rate for Payer: Healthscope Commercial |
$0.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.43
|
| Rate for Payer: PHP Commercial |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.45
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.38
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
OP
|
$0.51
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Aetna Commercial |
$0.43
|
| Rate for Payer: Aetna Medicare |
$0.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.20
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.40
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$0.41
|
| Rate for Payer: Cofinity Commercial |
$0.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.43
|
| Rate for Payer: PACE Senior Care Partners |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Commercial |
$0.43
|
| Rate for Payer: PHP Medicare Advantage |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.44
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.31
|
| Rate for Payer: Railroad Medicare Medicare |
$0.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.45
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.13
|
| Rate for Payer: UHC Medicare Advantage |
$0.13
|
| Rate for Payer: VA VA |
$0.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.38
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: BCBS Trust/PPO |
$36.32
|
| Rate for Payer: BCN Commercial |
$36.32
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$36.54
|
| Rate for Payer: BCN Commercial |
$36.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.75
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.75
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.16
|
| Rate for Payer: PACE SWMI |
$11.75
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Medicare |
$11.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.10
|
| Rate for Payer: VA VA |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: Aetna Medicare |
$29.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.31
|
| Rate for Payer: BCBS Complete |
$9.54
|
| Rate for Payer: BCBS MAPPO |
$28.25
|
| Rate for Payer: BCBS Trust/PPO |
$87.86
|
| Rate for Payer: BCN Commercial |
$87.86
|
| Rate for Payer: BCN Medicare Advantage |
$28.25
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.25
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Mclaren Medicaid |
$9.08
|
| Rate for Payer: Meridian Medicaid |
$9.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PACE Senior Care Partners |
$26.84
|
| Rate for Payer: PACE SWMI |
$28.25
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: PHP Medicare Advantage |
$28.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Medicare |
$28.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: Railroad Medicare Medicare |
$28.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.44
|
| Rate for Payer: UHC Core |
$94.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.25
|
| Rate for Payer: UHC Medicare Advantage |
$29.10
|
| Rate for Payer: VA VA |
$28.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.92 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: BCBS Trust/PPO |
$87.33
|
| Rate for Payer: BCN Commercial |
$87.33
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.44
|
| Rate for Payer: UHC Core |
$94.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
