|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
IP
|
$1,792.32
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,247.45 |
| Max. Negotiated Rate |
$1,613.09 |
| Rate for Payer: Aetna Commercial |
$1,523.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.28
|
| Rate for Payer: BCN Commercial |
$1,480.28
|
| Rate for Payer: Cash Price |
$1,433.86
|
| Rate for Payer: Cofinity Commercial |
$1,541.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.86
|
| Rate for Payer: Healthscope Commercial |
$1,613.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.47
|
| Rate for Payer: Nomi Health Commercial |
$1,469.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.24
|
| Rate for Payer: PHP Commercial |
$1,523.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,559.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,247.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,577.24
|
| Rate for Payer: UHC Core |
$1,496.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.24
|
|
|
HC NM UNLISTED PROC ENDOCRINE S
|
Facility
|
OP
|
$1,792.32
|
|
|
Service Code
|
CPT 60699
|
| Hospital Charge Code |
36100267
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.99 |
| Max. Negotiated Rate |
$1,613.09 |
| Rate for Payer: Aetna Commercial |
$1,523.47
|
| Rate for Payer: Aetna Medicare |
$466.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$560.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$560.10
|
| Rate for Payer: BCBS Complete |
$331.76
|
| Rate for Payer: BCBS MAPPO |
$448.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,473.47
|
| Rate for Payer: BCN Commercial |
$1,473.47
|
| Rate for Payer: BCN Medicare Advantage |
$448.08
|
| Rate for Payer: Cash Price |
$1,433.86
|
| Rate for Payer: Cofinity Commercial |
$1,541.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.08
|
| Rate for Payer: Healthscope Commercial |
$1,613.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.24
|
| Rate for Payer: Mclaren Medicaid |
$315.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$470.48
|
| Rate for Payer: Meridian Medicaid |
$331.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$515.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$492.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.47
|
| Rate for Payer: Nomi Health Commercial |
$1,469.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.24
|
| Rate for Payer: PACE Senior Care Partners |
$425.68
|
| Rate for Payer: PACE SWMI |
$448.08
|
| Rate for Payer: PHP Commercial |
$1,523.47
|
| Rate for Payer: PHP Medicare Advantage |
$448.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,559.32
|
| Rate for Payer: Priority Health Medicare |
$452.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,247.45
|
| Rate for Payer: Railroad Medicare Medicare |
$448.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,577.24
|
| Rate for Payer: UHC Core |
$1,496.59
|
| Rate for Payer: UHC Exchange |
$448.08
|
| Rate for Payer: UHC Medicaid |
$315.99
|
| Rate for Payer: UHC Medicare Advantage |
$448.08
|
| Rate for Payer: UHCCP Medicaid |
$315.99
|
| Rate for Payer: VA VA |
$448.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.24
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
IP
|
$1,699.68
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,182.98 |
| Max. Negotiated Rate |
$1,529.71 |
| Rate for Payer: Aetna Commercial |
$1,444.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,403.77
|
| Rate for Payer: BCN Commercial |
$1,403.77
|
| Rate for Payer: Cash Price |
$1,359.74
|
| Rate for Payer: Cofinity Commercial |
$1,461.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.74
|
| Rate for Payer: Healthscope Commercial |
$1,529.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,444.73
|
| Rate for Payer: Nomi Health Commercial |
$1,393.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,274.76
|
| Rate for Payer: PHP Commercial |
$1,444.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,478.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.72
|
| Rate for Payer: UHC Core |
$1,419.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.76
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
OP
|
$1,699.68
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$299.65 |
| Max. Negotiated Rate |
$1,529.71 |
| Rate for Payer: Aetna Commercial |
$1,444.73
|
| Rate for Payer: Aetna Medicare |
$441.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$531.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$531.15
|
| Rate for Payer: BCBS Complete |
$314.61
|
| Rate for Payer: BCBS MAPPO |
$424.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,397.31
|
| Rate for Payer: BCN Commercial |
$1,397.31
|
| Rate for Payer: BCN Medicare Advantage |
$424.92
|
| Rate for Payer: Cash Price |
$1,359.74
|
| Rate for Payer: Cofinity Commercial |
$1,461.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.92
|
| Rate for Payer: Healthscope Commercial |
$1,529.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.76
|
| Rate for Payer: Mclaren Medicaid |
$299.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.17
|
| Rate for Payer: Meridian Medicaid |
$314.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$488.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,444.73
|
| Rate for Payer: Nomi Health Commercial |
$1,393.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,274.76
|
| Rate for Payer: PACE Senior Care Partners |
$403.67
|
| Rate for Payer: PACE SWMI |
$424.92
|
| Rate for Payer: PHP Commercial |
$1,444.73
|
| Rate for Payer: PHP Medicare Advantage |
$424.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,478.72
|
| Rate for Payer: Priority Health Medicare |
$429.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.98
|
| Rate for Payer: Railroad Medicare Medicare |
$424.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.72
|
| Rate for Payer: UHC Core |
$1,419.23
|
| Rate for Payer: UHC Exchange |
$424.92
|
| Rate for Payer: UHC Medicaid |
$299.65
|
| Rate for Payer: UHC Medicare Advantage |
$424.92
|
| Rate for Payer: UHCCP Medicaid |
$299.65
|
| Rate for Payer: VA VA |
$424.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.76
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
IP
|
$1,243.56
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$865.52 |
| Max. Negotiated Rate |
$1,119.20 |
| Rate for Payer: Aetna Commercial |
$1,057.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,027.06
|
| Rate for Payer: BCN Commercial |
$1,027.06
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cofinity Commercial |
$1,069.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.85
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.03
|
| Rate for Payer: Nomi Health Commercial |
$1,019.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$932.67
|
| Rate for Payer: PHP Commercial |
$1,057.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,081.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$865.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,094.33
|
| Rate for Payer: UHC Core |
$1,038.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.67
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
OP
|
$1,243.56
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$1,119.20 |
| Rate for Payer: Aetna Commercial |
$1,057.03
|
| Rate for Payer: Aetna Medicare |
$323.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.61
|
| Rate for Payer: BCBS Complete |
$230.18
|
| Rate for Payer: BCBS MAPPO |
$310.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,022.33
|
| Rate for Payer: BCN Commercial |
$1,022.33
|
| Rate for Payer: BCN Medicare Advantage |
$310.89
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cofinity Commercial |
$1,069.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.89
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.67
|
| Rate for Payer: Mclaren Medicaid |
$219.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.43
|
| Rate for Payer: Meridian Medicaid |
$230.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.03
|
| Rate for Payer: Nomi Health Commercial |
$1,019.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$932.67
|
| Rate for Payer: PACE Senior Care Partners |
$295.35
|
| Rate for Payer: PACE SWMI |
$310.89
|
| Rate for Payer: PHP Commercial |
$1,057.03
|
| Rate for Payer: PHP Medicare Advantage |
$310.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,081.90
|
| Rate for Payer: Priority Health Medicare |
$314.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$865.52
|
| Rate for Payer: Railroad Medicare Medicare |
$310.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,094.33
|
| Rate for Payer: UHC Core |
$1,038.37
|
| Rate for Payer: UHC Exchange |
$310.89
|
| Rate for Payer: UHC Medicaid |
$219.24
|
| Rate for Payer: UHC Medicare Advantage |
$310.89
|
| Rate for Payer: UHCCP Medicaid |
$219.24
|
| Rate for Payer: VA VA |
$310.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.67
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
OP
|
$1,699.68
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$299.65 |
| Max. Negotiated Rate |
$1,529.71 |
| Rate for Payer: Aetna Commercial |
$1,444.73
|
| Rate for Payer: Aetna Medicare |
$441.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$531.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$531.15
|
| Rate for Payer: BCBS Complete |
$314.61
|
| Rate for Payer: BCBS MAPPO |
$424.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,397.31
|
| Rate for Payer: BCN Commercial |
$1,397.31
|
| Rate for Payer: BCN Medicare Advantage |
$424.92
|
| Rate for Payer: Cash Price |
$1,359.74
|
| Rate for Payer: Cofinity Commercial |
$1,461.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.92
|
| Rate for Payer: Healthscope Commercial |
$1,529.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.76
|
| Rate for Payer: Mclaren Medicaid |
$299.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$446.17
|
| Rate for Payer: Meridian Medicaid |
$314.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$488.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$467.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,444.73
|
| Rate for Payer: Nomi Health Commercial |
$1,393.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,274.76
|
| Rate for Payer: PACE Senior Care Partners |
$403.67
|
| Rate for Payer: PACE SWMI |
$424.92
|
| Rate for Payer: PHP Commercial |
$1,444.73
|
| Rate for Payer: PHP Medicare Advantage |
$424.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,478.72
|
| Rate for Payer: Priority Health Medicare |
$429.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.98
|
| Rate for Payer: Railroad Medicare Medicare |
$424.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.72
|
| Rate for Payer: UHC Core |
$1,419.23
|
| Rate for Payer: UHC Exchange |
$424.92
|
| Rate for Payer: UHC Medicaid |
$299.65
|
| Rate for Payer: UHC Medicare Advantage |
$424.92
|
| Rate for Payer: UHCCP Medicaid |
$299.65
|
| Rate for Payer: VA VA |
$424.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.76
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
IP
|
$1,699.68
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,182.98 |
| Max. Negotiated Rate |
$1,529.71 |
| Rate for Payer: Aetna Commercial |
$1,444.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,403.77
|
| Rate for Payer: BCN Commercial |
$1,403.77
|
| Rate for Payer: Cash Price |
$1,359.74
|
| Rate for Payer: Cofinity Commercial |
$1,461.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,359.74
|
| Rate for Payer: Healthscope Commercial |
$1,529.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,274.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,444.73
|
| Rate for Payer: Nomi Health Commercial |
$1,393.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,274.76
|
| Rate for Payer: PHP Commercial |
$1,444.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,478.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,182.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,495.72
|
| Rate for Payer: UHC Core |
$1,419.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,274.76
|
|
|
HC NM VOID CYSTO
|
Facility
|
OP
|
$1,090.67
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$192.29 |
| Max. Negotiated Rate |
$981.60 |
| Rate for Payer: Aetna Commercial |
$927.07
|
| Rate for Payer: Aetna Medicare |
$283.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$340.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$340.83
|
| Rate for Payer: BCBS Complete |
$201.88
|
| Rate for Payer: BCBS MAPPO |
$272.67
|
| Rate for Payer: BCBS Trust/PPO |
$896.64
|
| Rate for Payer: BCN Commercial |
$896.64
|
| Rate for Payer: BCN Medicare Advantage |
$272.67
|
| Rate for Payer: Cash Price |
$872.54
|
| Rate for Payer: Cofinity Commercial |
$937.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.67
|
| Rate for Payer: Healthscope Commercial |
$981.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.00
|
| Rate for Payer: Mclaren Medicaid |
$192.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.30
|
| Rate for Payer: Meridian Medicaid |
$201.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$313.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$299.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$927.07
|
| Rate for Payer: Nomi Health Commercial |
$894.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.00
|
| Rate for Payer: PACE Senior Care Partners |
$259.03
|
| Rate for Payer: PACE SWMI |
$272.67
|
| Rate for Payer: PHP Commercial |
$927.07
|
| Rate for Payer: PHP Medicare Advantage |
$272.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$948.88
|
| Rate for Payer: Priority Health Medicare |
$275.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$759.11
|
| Rate for Payer: Railroad Medicare Medicare |
$272.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.79
|
| Rate for Payer: UHC Core |
$910.71
|
| Rate for Payer: UHC Exchange |
$272.67
|
| Rate for Payer: UHC Medicaid |
$192.29
|
| Rate for Payer: UHC Medicare Advantage |
$272.67
|
| Rate for Payer: UHCCP Medicaid |
$192.29
|
| Rate for Payer: VA VA |
$272.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.00
|
|
|
HC NM VOID CYSTO
|
Facility
|
IP
|
$1,090.67
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$759.11 |
| Max. Negotiated Rate |
$981.60 |
| Rate for Payer: Aetna Commercial |
$927.07
|
| Rate for Payer: BCBS Trust/PPO |
$900.78
|
| Rate for Payer: BCN Commercial |
$900.78
|
| Rate for Payer: Cash Price |
$872.54
|
| Rate for Payer: Cofinity Commercial |
$937.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.54
|
| Rate for Payer: Healthscope Commercial |
$981.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$927.07
|
| Rate for Payer: Nomi Health Commercial |
$894.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.00
|
| Rate for Payer: PHP Commercial |
$927.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$948.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$759.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.79
|
| Rate for Payer: UHC Core |
$910.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.00
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
OP
|
$1,978.67
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$348.84 |
| Max. Negotiated Rate |
$1,780.80 |
| Rate for Payer: Aetna Commercial |
$1,681.87
|
| Rate for Payer: Aetna Medicare |
$514.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$618.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$618.33
|
| Rate for Payer: BCBS Complete |
$366.25
|
| Rate for Payer: BCBS MAPPO |
$494.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.66
|
| Rate for Payer: BCN Commercial |
$1,626.66
|
| Rate for Payer: BCN Medicare Advantage |
$494.67
|
| Rate for Payer: Cash Price |
$1,582.94
|
| Rate for Payer: Cofinity Commercial |
$1,701.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$494.67
|
| Rate for Payer: Healthscope Commercial |
$1,780.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,484.00
|
| Rate for Payer: Mclaren Medicaid |
$348.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$519.40
|
| Rate for Payer: Meridian Medicaid |
$366.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$568.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$544.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.87
|
| Rate for Payer: Nomi Health Commercial |
$1,622.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.00
|
| Rate for Payer: PACE Senior Care Partners |
$469.93
|
| Rate for Payer: PACE SWMI |
$494.67
|
| Rate for Payer: PHP Commercial |
$1,681.87
|
| Rate for Payer: PHP Medicare Advantage |
$494.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,721.44
|
| Rate for Payer: Priority Health Medicare |
$499.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,377.15
|
| Rate for Payer: Railroad Medicare Medicare |
$494.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,741.23
|
| Rate for Payer: UHC Core |
$1,652.19
|
| Rate for Payer: UHC Exchange |
$494.67
|
| Rate for Payer: UHC Medicaid |
$348.84
|
| Rate for Payer: UHC Medicare Advantage |
$494.67
|
| Rate for Payer: UHCCP Medicaid |
$348.84
|
| Rate for Payer: VA VA |
$494.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,484.00
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
IP
|
$1,978.67
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,377.15 |
| Max. Negotiated Rate |
$1,780.80 |
| Rate for Payer: Aetna Commercial |
$1,681.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,634.18
|
| Rate for Payer: BCN Commercial |
$1,634.18
|
| Rate for Payer: Cash Price |
$1,582.94
|
| Rate for Payer: Cofinity Commercial |
$1,701.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,582.94
|
| Rate for Payer: Healthscope Commercial |
$1,780.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,484.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,681.87
|
| Rate for Payer: Nomi Health Commercial |
$1,622.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,484.00
|
| Rate for Payer: PHP Commercial |
$1,681.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,721.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,377.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,741.23
|
| Rate for Payer: UHC Core |
$1,652.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,484.00
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
OP
|
$1.04
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.94 |
| Rate for Payer: Aetna Commercial |
$0.88
|
| Rate for Payer: Aetna Medicare |
$0.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.33
|
| Rate for Payer: BCBS Complete |
$0.19
|
| Rate for Payer: BCBS MAPPO |
$0.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.85
|
| Rate for Payer: BCN Commercial |
$0.85
|
| Rate for Payer: BCN Medicare Advantage |
$0.26
|
| Rate for Payer: Cash Price |
$0.83
|
| Rate for Payer: Cofinity Commercial |
$0.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.26
|
| Rate for Payer: Healthscope Commercial |
$0.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.78
|
| Rate for Payer: Mclaren Medicaid |
$0.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.27
|
| Rate for Payer: Meridian Medicaid |
$0.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.88
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.78
|
| Rate for Payer: PACE Senior Care Partners |
$0.25
|
| Rate for Payer: PACE SWMI |
$0.26
|
| Rate for Payer: PHP Commercial |
$0.88
|
| Rate for Payer: PHP Medicare Advantage |
$0.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.90
|
| Rate for Payer: Priority Health Medicare |
$0.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.72
|
| Rate for Payer: Railroad Medicare Medicare |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.92
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHC Medicaid |
$0.18
|
| Rate for Payer: UHC Medicare Advantage |
$0.26
|
| Rate for Payer: UHCCP Medicaid |
$0.18
|
| Rate for Payer: VA VA |
$0.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.78
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
IP
|
$1.04
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$0.94 |
| Rate for Payer: Aetna Commercial |
$0.88
|
| Rate for Payer: BCBS Trust/PPO |
$0.86
|
| Rate for Payer: BCN Commercial |
$0.86
|
| Rate for Payer: Cash Price |
$0.83
|
| Rate for Payer: Cofinity Commercial |
$0.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.83
|
| Rate for Payer: Healthscope Commercial |
$0.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.88
|
| Rate for Payer: Nomi Health Commercial |
$0.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.78
|
| Rate for Payer: PHP Commercial |
$0.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.92
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.78
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
IP
|
$89.05
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$61.98 |
| Max. Negotiated Rate |
$80.14 |
| Rate for Payer: Aetna Commercial |
$75.69
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$73.55
|
| Rate for Payer: Cash Price |
$71.24
|
| Rate for Payer: Cofinity Commercial |
$76.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$80.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.69
|
| Rate for Payer: Nomi Health Commercial |
$73.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.79
|
| Rate for Payer: PHP Commercial |
$75.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.36
|
| Rate for Payer: UHC Core |
$74.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.79
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
OP
|
$89.05
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.70 |
| Max. Negotiated Rate |
$80.14 |
| Rate for Payer: Aetna Commercial |
$75.69
|
| Rate for Payer: Aetna Medicare |
$23.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.83
|
| Rate for Payer: BCBS Complete |
$16.48
|
| Rate for Payer: BCBS MAPPO |
$22.26
|
| Rate for Payer: BCBS Trust/PPO |
$73.21
|
| Rate for Payer: BCN Commercial |
$73.21
|
| Rate for Payer: BCN Medicare Advantage |
$22.26
|
| Rate for Payer: Cash Price |
$71.24
|
| Rate for Payer: Cofinity Commercial |
$76.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.26
|
| Rate for Payer: Healthscope Commercial |
$80.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.79
|
| Rate for Payer: Mclaren Medicaid |
$15.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.38
|
| Rate for Payer: Meridian Medicaid |
$16.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.69
|
| Rate for Payer: Nomi Health Commercial |
$73.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.79
|
| Rate for Payer: PACE Senior Care Partners |
$21.15
|
| Rate for Payer: PACE SWMI |
$22.26
|
| Rate for Payer: PHP Commercial |
$75.69
|
| Rate for Payer: PHP Medicare Advantage |
$22.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.47
|
| Rate for Payer: Priority Health Medicare |
$22.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.98
|
| Rate for Payer: Railroad Medicare Medicare |
$22.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.36
|
| Rate for Payer: UHC Core |
$74.36
|
| Rate for Payer: UHC Exchange |
$22.26
|
| Rate for Payer: UHC Medicaid |
$15.70
|
| Rate for Payer: UHC Medicare Advantage |
$22.26
|
| Rate for Payer: UHCCP Medicaid |
$15.70
|
| Rate for Payer: VA VA |
$22.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.79
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
IP
|
$2,519.13
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,753.31 |
| Max. Negotiated Rate |
$2,267.22 |
| Rate for Payer: Aetna Commercial |
$2,141.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,080.55
|
| Rate for Payer: BCN Commercial |
$2,080.55
|
| Rate for Payer: Cash Price |
$2,015.30
|
| Rate for Payer: Cofinity Commercial |
$2,166.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,015.30
|
| Rate for Payer: Healthscope Commercial |
$2,267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,889.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,141.26
|
| Rate for Payer: Nomi Health Commercial |
$2,065.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,889.35
|
| Rate for Payer: PHP Commercial |
$2,141.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,191.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,753.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,216.83
|
| Rate for Payer: UHC Core |
$2,103.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,889.35
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
OP
|
$2,519.13
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$444.12 |
| Max. Negotiated Rate |
$2,267.22 |
| Rate for Payer: Aetna Commercial |
$2,141.26
|
| Rate for Payer: Aetna Medicare |
$654.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$787.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$787.23
|
| Rate for Payer: BCBS Complete |
$466.29
|
| Rate for Payer: BCBS MAPPO |
$629.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,070.98
|
| Rate for Payer: BCN Commercial |
$2,070.98
|
| Rate for Payer: BCN Medicare Advantage |
$629.78
|
| Rate for Payer: Cash Price |
$2,015.30
|
| Rate for Payer: Cofinity Commercial |
$2,166.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,015.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.78
|
| Rate for Payer: Healthscope Commercial |
$2,267.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,889.35
|
| Rate for Payer: Mclaren Medicaid |
$444.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$661.27
|
| Rate for Payer: Meridian Medicaid |
$466.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$724.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$692.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,141.26
|
| Rate for Payer: Nomi Health Commercial |
$2,065.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,889.35
|
| Rate for Payer: PACE Senior Care Partners |
$598.29
|
| Rate for Payer: PACE SWMI |
$629.78
|
| Rate for Payer: PHP Commercial |
$2,141.26
|
| Rate for Payer: PHP Medicare Advantage |
$629.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,191.64
|
| Rate for Payer: Priority Health Medicare |
$636.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,753.31
|
| Rate for Payer: Railroad Medicare Medicare |
$629.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,216.83
|
| Rate for Payer: UHC Core |
$2,103.47
|
| Rate for Payer: UHC Exchange |
$629.78
|
| Rate for Payer: UHC Medicaid |
$444.12
|
| Rate for Payer: UHC Medicare Advantage |
$629.78
|
| Rate for Payer: UHCCP Medicaid |
$444.12
|
| Rate for Payer: VA VA |
$629.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,889.35
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$1,155.32
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$804.10 |
| Max. Negotiated Rate |
$1,039.79 |
| Rate for Payer: Aetna Commercial |
$982.02
|
| Rate for Payer: BCBS Trust/PPO |
$954.18
|
| Rate for Payer: BCN Commercial |
$954.18
|
| Rate for Payer: Cash Price |
$924.26
|
| Rate for Payer: Cofinity Commercial |
$993.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.26
|
| Rate for Payer: Healthscope Commercial |
$1,039.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$866.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$982.02
|
| Rate for Payer: Nomi Health Commercial |
$947.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$866.49
|
| Rate for Payer: PHP Commercial |
$982.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,005.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$804.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.68
|
| Rate for Payer: UHC Core |
$964.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$866.49
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$1,155.32
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$203.68 |
| Max. Negotiated Rate |
$1,039.79 |
| Rate for Payer: Aetna Commercial |
$982.02
|
| Rate for Payer: Aetna Medicare |
$300.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.04
|
| Rate for Payer: BCBS Complete |
$213.85
|
| Rate for Payer: BCBS MAPPO |
$288.83
|
| Rate for Payer: BCBS Trust/PPO |
$949.79
|
| Rate for Payer: BCN Commercial |
$949.79
|
| Rate for Payer: BCN Medicare Advantage |
$288.83
|
| Rate for Payer: Cash Price |
$924.26
|
| Rate for Payer: Cofinity Commercial |
$993.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.83
|
| Rate for Payer: Healthscope Commercial |
$1,039.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$866.49
|
| Rate for Payer: Mclaren Medicaid |
$203.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.27
|
| Rate for Payer: Meridian Medicaid |
$213.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$982.02
|
| Rate for Payer: Nomi Health Commercial |
$947.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$866.49
|
| Rate for Payer: PACE Senior Care Partners |
$274.39
|
| Rate for Payer: PACE SWMI |
$288.83
|
| Rate for Payer: PHP Commercial |
$982.02
|
| Rate for Payer: PHP Medicare Advantage |
$288.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,005.13
|
| Rate for Payer: Priority Health Medicare |
$291.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$804.10
|
| Rate for Payer: Railroad Medicare Medicare |
$288.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,016.68
|
| Rate for Payer: UHC Core |
$964.69
|
| Rate for Payer: UHC Exchange |
$288.83
|
| Rate for Payer: UHC Medicaid |
$203.68
|
| Rate for Payer: UHC Medicare Advantage |
$288.83
|
| Rate for Payer: UHCCP Medicaid |
$203.68
|
| Rate for Payer: VA VA |
$288.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$866.49
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
IP
|
$942.80
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$656.19 |
| Max. Negotiated Rate |
$848.52 |
| Rate for Payer: Aetna Commercial |
$801.38
|
| Rate for Payer: BCBS Trust/PPO |
$778.66
|
| Rate for Payer: BCN Commercial |
$778.66
|
| Rate for Payer: Cash Price |
$754.24
|
| Rate for Payer: Cofinity Commercial |
$810.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.24
|
| Rate for Payer: Healthscope Commercial |
$848.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.38
|
| Rate for Payer: Nomi Health Commercial |
$773.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.10
|
| Rate for Payer: PHP Commercial |
$801.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$820.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.66
|
| Rate for Payer: UHC Core |
$787.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.10
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
OP
|
$942.80
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$166.22 |
| Max. Negotiated Rate |
$848.52 |
| Rate for Payer: Aetna Commercial |
$801.38
|
| Rate for Payer: Aetna Medicare |
$245.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.62
|
| Rate for Payer: BCBS Complete |
$174.51
|
| Rate for Payer: BCBS MAPPO |
$235.70
|
| Rate for Payer: BCBS Trust/PPO |
$775.08
|
| Rate for Payer: BCN Commercial |
$775.08
|
| Rate for Payer: BCN Medicare Advantage |
$235.70
|
| Rate for Payer: Cash Price |
$754.24
|
| Rate for Payer: Cofinity Commercial |
$810.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.70
|
| Rate for Payer: Healthscope Commercial |
$848.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.10
|
| Rate for Payer: Mclaren Medicaid |
$166.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.49
|
| Rate for Payer: Meridian Medicaid |
$174.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.38
|
| Rate for Payer: Nomi Health Commercial |
$773.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.10
|
| Rate for Payer: PACE Senior Care Partners |
$223.91
|
| Rate for Payer: PACE SWMI |
$235.70
|
| Rate for Payer: PHP Commercial |
$801.38
|
| Rate for Payer: PHP Medicare Advantage |
$235.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$820.24
|
| Rate for Payer: Priority Health Medicare |
$238.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.19
|
| Rate for Payer: Railroad Medicare Medicare |
$235.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.66
|
| Rate for Payer: UHC Core |
$787.24
|
| Rate for Payer: UHC Exchange |
$235.70
|
| Rate for Payer: UHC Medicaid |
$166.22
|
| Rate for Payer: UHC Medicare Advantage |
$235.70
|
| Rate for Payer: UHCCP Medicaid |
$166.22
|
| Rate for Payer: VA VA |
$235.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.10
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
IP
|
$366.12
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.82 |
| Max. Negotiated Rate |
$329.51 |
| Rate for Payer: Aetna Commercial |
$311.20
|
| Rate for Payer: BCBS Trust/PPO |
$302.38
|
| Rate for Payer: BCN Commercial |
$302.38
|
| Rate for Payer: Cash Price |
$292.90
|
| Rate for Payer: Cofinity Commercial |
$314.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.90
|
| Rate for Payer: Healthscope Commercial |
$329.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.20
|
| Rate for Payer: Nomi Health Commercial |
$300.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.59
|
| Rate for Payer: PHP Commercial |
$311.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.19
|
| Rate for Payer: UHC Core |
$305.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.59
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
OP
|
$366.12
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.55 |
| Max. Negotiated Rate |
$329.51 |
| Rate for Payer: Aetna Commercial |
$311.20
|
| Rate for Payer: Aetna Medicare |
$95.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.41
|
| Rate for Payer: BCBS Complete |
$67.77
|
| Rate for Payer: BCBS MAPPO |
$91.53
|
| Rate for Payer: BCBS Trust/PPO |
$300.99
|
| Rate for Payer: BCN Commercial |
$300.99
|
| Rate for Payer: BCN Medicare Advantage |
$91.53
|
| Rate for Payer: Cash Price |
$292.90
|
| Rate for Payer: Cofinity Commercial |
$314.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.53
|
| Rate for Payer: Healthscope Commercial |
$329.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.59
|
| Rate for Payer: Mclaren Medicaid |
$64.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.11
|
| Rate for Payer: Meridian Medicaid |
$67.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.20
|
| Rate for Payer: Nomi Health Commercial |
$300.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.59
|
| Rate for Payer: PACE Senior Care Partners |
$86.95
|
| Rate for Payer: PACE SWMI |
$91.53
|
| Rate for Payer: PHP Commercial |
$311.20
|
| Rate for Payer: PHP Medicare Advantage |
$91.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.52
|
| Rate for Payer: Priority Health Medicare |
$92.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.82
|
| Rate for Payer: Railroad Medicare Medicare |
$91.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.19
|
| Rate for Payer: UHC Core |
$305.71
|
| Rate for Payer: UHC Exchange |
$91.53
|
| Rate for Payer: UHC Medicaid |
$64.55
|
| Rate for Payer: UHC Medicare Advantage |
$91.53
|
| Rate for Payer: UHCCP Medicaid |
$64.55
|
| Rate for Payer: VA VA |
$91.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.59
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
IP
|
$4,034.29
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,807.87 |
| Max. Negotiated Rate |
$3,630.86 |
| Rate for Payer: Aetna Commercial |
$3,429.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,331.92
|
| Rate for Payer: BCN Commercial |
$3,331.92
|
| Rate for Payer: Cash Price |
$3,227.43
|
| Rate for Payer: Cofinity Commercial |
$3,469.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,227.43
|
| Rate for Payer: Healthscope Commercial |
$3,630.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,025.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,429.15
|
| Rate for Payer: Nomi Health Commercial |
$3,308.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,025.72
|
| Rate for Payer: PHP Commercial |
$3,429.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,509.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,807.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,550.18
|
| Rate for Payer: UHC Core |
$3,368.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,025.72
|
|
