|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$915.00
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$217.31 |
| Max. Negotiated Rate |
$823.50 |
| Rate for Payer: Aetna Commercial |
$777.75
|
| Rate for Payer: Aetna Medicare |
$237.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$285.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$285.94
|
| Rate for Payer: BCBS Complete |
$366.00
|
| Rate for Payer: BCBS MAPPO |
$228.75
|
| Rate for Payer: BCBS Trust/PPO |
$711.41
|
| Rate for Payer: BCN Commercial |
$711.41
|
| Rate for Payer: BCN Medicare Advantage |
$228.75
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cofinity Commercial |
$786.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$732.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.75
|
| Rate for Payer: Healthscope Commercial |
$823.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$686.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$240.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$263.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$777.75
|
| Rate for Payer: PACE Senior Care Partners |
$217.31
|
| Rate for Payer: PACE SWMI |
$228.75
|
| Rate for Payer: PHP Commercial |
$777.75
|
| Rate for Payer: PHP Medicare Advantage |
$228.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.05
|
| Rate for Payer: Priority Health Medicare |
$228.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$558.06
|
| Rate for Payer: Railroad Medicare Medicare |
$228.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$805.20
|
| Rate for Payer: UHC Core |
$764.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.75
|
| Rate for Payer: UHC Medicare Advantage |
$235.61
|
| Rate for Payer: VA VA |
$228.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$686.25
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$915.00
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$558.06 |
| Max. Negotiated Rate |
$823.50 |
| Rate for Payer: Aetna Commercial |
$777.75
|
| Rate for Payer: BCBS Trust/PPO |
$707.11
|
| Rate for Payer: BCN Commercial |
$707.11
|
| Rate for Payer: Cash Price |
$732.00
|
| Rate for Payer: Cofinity Commercial |
$786.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$732.00
|
| Rate for Payer: Healthscope Commercial |
$823.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$686.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$777.75
|
| Rate for Payer: PHP Commercial |
$777.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$640.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$558.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$805.20
|
| Rate for Payer: UHC Core |
$764.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$686.25
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.27 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna Medicare |
$37.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.62
|
| Rate for Payer: BCBS Complete |
$13.93
|
| Rate for Payer: BCBS MAPPO |
$36.50
|
| Rate for Payer: BCBS Trust/PPO |
$113.52
|
| Rate for Payer: BCN Commercial |
$113.52
|
| Rate for Payer: BCN Medicare Advantage |
$36.50
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$13.27
|
| Rate for Payer: Meridian Medicaid |
$13.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PACE Senior Care Partners |
$34.68
|
| Rate for Payer: PACE SWMI |
$36.50
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: PHP Medicare Advantage |
$36.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Medicare |
$36.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: Railroad Medicare Medicare |
$36.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.50
|
| Rate for Payer: UHC Medicare Advantage |
$37.60
|
| Rate for Payer: VA VA |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.05 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: BCBS Trust/PPO |
$112.83
|
| Rate for Payer: BCN Commercial |
$112.83
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC STANDBY OPEN HEART
|
Facility
|
IP
|
$2,370.24
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,445.61 |
| Max. Negotiated Rate |
$2,133.22 |
| Rate for Payer: Aetna Commercial |
$2,014.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.72
|
| Rate for Payer: BCN Commercial |
$1,831.72
|
| Rate for Payer: Cash Price |
$1,896.19
|
| Rate for Payer: Cofinity Commercial |
$2,038.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.19
|
| Rate for Payer: Healthscope Commercial |
$2,133.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,777.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,014.70
|
| Rate for Payer: PHP Commercial |
$2,014.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,659.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,062.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,445.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,085.81
|
| Rate for Payer: UHC Core |
$1,979.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,777.68
|
|
|
HC STANDBY OPEN HEART
|
Facility
|
OP
|
$2,370.24
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$562.93 |
| Max. Negotiated Rate |
$2,133.22 |
| Rate for Payer: Aetna Commercial |
$2,014.70
|
| Rate for Payer: Aetna Medicare |
$616.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$740.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$740.70
|
| Rate for Payer: BCBS Complete |
$948.10
|
| Rate for Payer: BCBS MAPPO |
$592.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,842.86
|
| Rate for Payer: BCN Commercial |
$1,842.86
|
| Rate for Payer: BCN Medicare Advantage |
$592.56
|
| Rate for Payer: Cash Price |
$1,896.19
|
| Rate for Payer: Cofinity Commercial |
$2,038.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.56
|
| Rate for Payer: Healthscope Commercial |
$2,133.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,777.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$622.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$681.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,014.70
|
| Rate for Payer: PACE Senior Care Partners |
$562.93
|
| Rate for Payer: PACE SWMI |
$592.56
|
| Rate for Payer: PHP Commercial |
$2,014.70
|
| Rate for Payer: PHP Medicare Advantage |
$592.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,659.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,062.11
|
| Rate for Payer: Priority Health Medicare |
$592.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,445.61
|
| Rate for Payer: Railroad Medicare Medicare |
$592.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,085.81
|
| Rate for Payer: UHC Core |
$1,979.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$592.56
|
| Rate for Payer: UHC Medicare Advantage |
$610.34
|
| Rate for Payer: VA VA |
$592.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,777.68
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: Aetna Medicare |
$14.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.19
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$13.75
|
| Rate for Payer: BCBS Trust/PPO |
$42.76
|
| Rate for Payer: BCN Commercial |
$42.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.75
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$47.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.75
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.25
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PACE Senior Care Partners |
$13.06
|
| Rate for Payer: PACE SWMI |
$13.75
|
| Rate for Payer: PHP Commercial |
$46.75
|
| Rate for Payer: PHP Medicare Advantage |
$13.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.85
|
| Rate for Payer: Priority Health Medicare |
$13.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.54
|
| Rate for Payer: Railroad Medicare Medicare |
$13.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.40
|
| Rate for Payer: UHC Core |
$45.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.75
|
| Rate for Payer: UHC Medicare Advantage |
$14.16
|
| Rate for Payer: VA VA |
$13.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.25
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.54 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: BCBS Trust/PPO |
$42.50
|
| Rate for Payer: BCN Commercial |
$42.50
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$47.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PHP Commercial |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.40
|
| Rate for Payer: UHC Core |
$45.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.25
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$60.48
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.36 |
| Max. Negotiated Rate |
$54.43 |
| Rate for Payer: Aetna Commercial |
$51.41
|
| Rate for Payer: Aetna Medicare |
$15.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.90
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$15.12
|
| Rate for Payer: BCBS Trust/PPO |
$47.02
|
| Rate for Payer: BCN Commercial |
$47.02
|
| Rate for Payer: BCN Medicare Advantage |
$15.12
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cofinity Commercial |
$52.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.12
|
| Rate for Payer: Healthscope Commercial |
$54.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.36
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.41
|
| Rate for Payer: PACE Senior Care Partners |
$14.36
|
| Rate for Payer: PACE SWMI |
$15.12
|
| Rate for Payer: PHP Commercial |
$51.41
|
| Rate for Payer: PHP Medicare Advantage |
$15.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.62
|
| Rate for Payer: Priority Health Medicare |
$15.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.89
|
| Rate for Payer: Railroad Medicare Medicare |
$15.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.22
|
| Rate for Payer: UHC Core |
$50.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.12
|
| Rate for Payer: UHC Medicare Advantage |
$15.57
|
| Rate for Payer: VA VA |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.36
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$60.48
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.89 |
| Max. Negotiated Rate |
$54.43 |
| Rate for Payer: Aetna Commercial |
$51.41
|
| Rate for Payer: BCBS Trust/PPO |
$46.74
|
| Rate for Payer: BCN Commercial |
$46.74
|
| Rate for Payer: Cash Price |
$48.38
|
| Rate for Payer: Cofinity Commercial |
$52.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.38
|
| Rate for Payer: Healthscope Commercial |
$54.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.41
|
| Rate for Payer: PHP Commercial |
$51.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.22
|
| Rate for Payer: UHC Core |
$50.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.36
|
|
|
HC STATLOCK
|
Facility
|
OP
|
$140.87
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.46 |
| Max. Negotiated Rate |
$126.78 |
| Rate for Payer: Aetna Commercial |
$119.74
|
| Rate for Payer: Aetna Medicare |
$36.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.02
|
| Rate for Payer: BCBS Complete |
$56.35
|
| Rate for Payer: BCBS MAPPO |
$35.22
|
| Rate for Payer: BCBS Trust/PPO |
$109.53
|
| Rate for Payer: BCN Commercial |
$109.53
|
| Rate for Payer: BCN Medicare Advantage |
$35.22
|
| Rate for Payer: Cash Price |
$112.70
|
| Rate for Payer: Cofinity Commercial |
$121.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.22
|
| Rate for Payer: Healthscope Commercial |
$126.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.74
|
| Rate for Payer: PACE Senior Care Partners |
$33.46
|
| Rate for Payer: PACE SWMI |
$35.22
|
| Rate for Payer: PHP Commercial |
$119.74
|
| Rate for Payer: PHP Medicare Advantage |
$35.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.56
|
| Rate for Payer: Priority Health Medicare |
$35.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.92
|
| Rate for Payer: Railroad Medicare Medicare |
$35.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.97
|
| Rate for Payer: UHC Core |
$117.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.22
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$35.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.65
|
|
|
HC STATLOCK
|
Facility
|
IP
|
$140.87
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.92 |
| Max. Negotiated Rate |
$126.78 |
| Rate for Payer: Aetna Commercial |
$119.74
|
| Rate for Payer: BCBS Trust/PPO |
$108.86
|
| Rate for Payer: BCN Commercial |
$108.86
|
| Rate for Payer: Cash Price |
$112.70
|
| Rate for Payer: Cofinity Commercial |
$121.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.70
|
| Rate for Payer: Healthscope Commercial |
$126.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.74
|
| Rate for Payer: PHP Commercial |
$119.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.97
|
| Rate for Payer: UHC Core |
$117.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.65
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.74 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$28.90
|
| Rate for Payer: BCBS Trust/PPO |
$26.28
|
| Rate for Payer: BCN Commercial |
$26.28
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$29.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.20
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.90
|
| Rate for Payer: PHP Commercial |
$28.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Core |
$28.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.50
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$42.13 |
| Rate for Payer: Aetna Commercial |
$28.90
|
| Rate for Payer: Aetna Medicare |
$8.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.62
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$8.50
|
| Rate for Payer: BCBS Trust/PPO |
$26.44
|
| Rate for Payer: BCN Commercial |
$26.44
|
| Rate for Payer: BCN Medicare Advantage |
$8.50
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$29.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.50
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.50
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.08
|
| Rate for Payer: PACE SWMI |
$8.50
|
| Rate for Payer: PHP Commercial |
$28.90
|
| Rate for Payer: PHP Medicare Advantage |
$8.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.58
|
| Rate for Payer: Priority Health Medicare |
$8.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.74
|
| Rate for Payer: Railroad Medicare Medicare |
$8.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Core |
$28.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.50
|
| Rate for Payer: UHC Medicare Advantage |
$8.76
|
| Rate for Payer: VA VA |
$8.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.50
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
OP
|
$1,421.00
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$337.49 |
| Max. Negotiated Rate |
$1,278.90 |
| Rate for Payer: Aetna Commercial |
$1,207.85
|
| Rate for Payer: Aetna Medicare |
$369.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$444.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$444.06
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$355.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,104.83
|
| Rate for Payer: BCN Commercial |
$1,104.83
|
| Rate for Payer: BCN Medicare Advantage |
$355.25
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,222.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.25
|
| Rate for Payer: Healthscope Commercial |
$1,278.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.75
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$373.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.85
|
| Rate for Payer: PACE Senior Care Partners |
$337.49
|
| Rate for Payer: PACE SWMI |
$355.25
|
| Rate for Payer: PHP Commercial |
$1,207.85
|
| Rate for Payer: PHP Medicare Advantage |
$355.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,236.27
|
| Rate for Payer: Priority Health Medicare |
$355.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.67
|
| Rate for Payer: Railroad Medicare Medicare |
$355.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,250.48
|
| Rate for Payer: UHC Core |
$1,186.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$355.25
|
| Rate for Payer: UHC Medicare Advantage |
$365.91
|
| Rate for Payer: VA VA |
$355.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.75
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
IP
|
$1,421.00
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$866.67 |
| Max. Negotiated Rate |
$1,278.90 |
| Rate for Payer: Aetna Commercial |
$1,207.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.15
|
| Rate for Payer: BCN Commercial |
$1,098.15
|
| Rate for Payer: Cash Price |
$1,136.80
|
| Rate for Payer: Cofinity Commercial |
$1,222.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.80
|
| Rate for Payer: Healthscope Commercial |
$1,278.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.85
|
| Rate for Payer: PHP Commercial |
$1,207.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,236.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,250.48
|
| Rate for Payer: UHC Core |
$1,186.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.75
|
|
|
HC STENT
|
Facility
|
OP
|
$934.47
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.94 |
| Max. Negotiated Rate |
$841.02 |
| Rate for Payer: Aetna Commercial |
$794.30
|
| Rate for Payer: Aetna Medicare |
$242.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.02
|
| Rate for Payer: BCBS Complete |
$373.79
|
| Rate for Payer: BCBS MAPPO |
$233.62
|
| Rate for Payer: BCBS Trust/PPO |
$726.55
|
| Rate for Payer: BCN Commercial |
$726.55
|
| Rate for Payer: BCN Medicare Advantage |
$233.62
|
| Rate for Payer: Cash Price |
$747.58
|
| Rate for Payer: Cofinity Commercial |
$803.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.62
|
| Rate for Payer: Healthscope Commercial |
$841.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$245.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$794.30
|
| Rate for Payer: PACE Senior Care Partners |
$221.94
|
| Rate for Payer: PACE SWMI |
$233.62
|
| Rate for Payer: PHP Commercial |
$794.30
|
| Rate for Payer: PHP Medicare Advantage |
$233.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$654.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$812.99
|
| Rate for Payer: Priority Health Medicare |
$233.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.93
|
| Rate for Payer: Railroad Medicare Medicare |
$233.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.33
|
| Rate for Payer: UHC Core |
$780.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.62
|
| Rate for Payer: UHC Medicare Advantage |
$240.63
|
| Rate for Payer: VA VA |
$233.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.85
|
|
|
HC STENT
|
Facility
|
IP
|
$934.47
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$569.93 |
| Max. Negotiated Rate |
$841.02 |
| Rate for Payer: Aetna Commercial |
$794.30
|
| Rate for Payer: BCBS Trust/PPO |
$722.16
|
| Rate for Payer: BCN Commercial |
$722.16
|
| Rate for Payer: Cash Price |
$747.58
|
| Rate for Payer: Cofinity Commercial |
$803.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.58
|
| Rate for Payer: Healthscope Commercial |
$841.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$794.30
|
| Rate for Payer: PHP Commercial |
$794.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$654.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$812.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.33
|
| Rate for Payer: UHC Core |
$780.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.85
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
OP
|
$16,677.03
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,960.79 |
| Max. Negotiated Rate |
$15,009.33 |
| Rate for Payer: Aetna Commercial |
$14,175.48
|
| Rate for Payer: Aetna Medicare |
$4,336.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,211.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,211.57
|
| Rate for Payer: BCBS Complete |
$6,670.81
|
| Rate for Payer: BCBS MAPPO |
$4,169.26
|
| Rate for Payer: BCBS Trust/PPO |
$12,966.39
|
| Rate for Payer: BCN Commercial |
$12,966.39
|
| Rate for Payer: BCN Medicare Advantage |
$4,169.26
|
| Rate for Payer: Cash Price |
$13,341.62
|
| Rate for Payer: Cofinity Commercial |
$14,342.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,169.26
|
| Rate for Payer: Healthscope Commercial |
$15,009.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,507.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,377.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,794.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
| Rate for Payer: PACE Senior Care Partners |
$3,960.79
|
| Rate for Payer: PACE SWMI |
$4,169.26
|
| Rate for Payer: PHP Commercial |
$14,175.48
|
| Rate for Payer: PHP Medicare Advantage |
$4,169.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,509.02
|
| Rate for Payer: Priority Health Medicare |
$4,169.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,171.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4,169.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,675.79
|
| Rate for Payer: UHC Core |
$13,925.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,169.26
|
| Rate for Payer: UHC Medicare Advantage |
$4,294.34
|
| Rate for Payer: VA VA |
$4,169.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,507.77
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
IP
|
$16,677.03
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,171.32 |
| Max. Negotiated Rate |
$15,009.33 |
| Rate for Payer: Aetna Commercial |
$14,175.48
|
| Rate for Payer: BCBS Trust/PPO |
$12,888.01
|
| Rate for Payer: BCN Commercial |
$12,888.01
|
| Rate for Payer: Cash Price |
$13,341.62
|
| Rate for Payer: Cofinity Commercial |
$14,342.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
| Rate for Payer: Healthscope Commercial |
$15,009.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,507.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
| Rate for Payer: PHP Commercial |
$14,175.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,509.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,171.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,675.79
|
| Rate for Payer: UHC Core |
$13,925.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,507.77
|
|
|
HC STENT COATED W DELIVERY SYSTEM
|
Facility
|
OP
|
$11,642.46
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,765.08 |
| Max. Negotiated Rate |
$10,478.21 |
| Rate for Payer: Aetna Commercial |
$9,896.09
|
| Rate for Payer: Aetna Medicare |
$3,027.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,638.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,638.27
|
| Rate for Payer: BCBS Complete |
$4,656.98
|
| Rate for Payer: BCBS MAPPO |
$2,910.62
|
| Rate for Payer: BCBS Trust/PPO |
$9,052.01
|
| Rate for Payer: BCN Commercial |
$9,052.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,910.62
|
| Rate for Payer: Cash Price |
$9,313.97
|
| Rate for Payer: Cofinity Commercial |
$10,012.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,313.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,910.62
|
| Rate for Payer: Healthscope Commercial |
$10,478.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,731.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,056.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,347.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,896.09
|
| Rate for Payer: PACE Senior Care Partners |
$2,765.08
|
| Rate for Payer: PACE SWMI |
$2,910.62
|
| Rate for Payer: PHP Commercial |
$9,896.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,910.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,149.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,128.94
|
| Rate for Payer: Priority Health Medicare |
$2,910.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,100.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,910.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,245.36
|
| Rate for Payer: UHC Core |
$9,721.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,910.62
|
| Rate for Payer: UHC Medicare Advantage |
$2,997.93
|
| Rate for Payer: VA VA |
$2,910.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,731.84
|
|
|
HC STENT COATED W DELIVERY SYSTEM
|
Facility
|
IP
|
$11,642.46
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,100.74 |
| Max. Negotiated Rate |
$10,478.21 |
| Rate for Payer: Aetna Commercial |
$9,896.09
|
| Rate for Payer: BCBS Trust/PPO |
$8,997.29
|
| Rate for Payer: BCN Commercial |
$8,997.29
|
| Rate for Payer: Cash Price |
$9,313.97
|
| Rate for Payer: Cofinity Commercial |
$10,012.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,313.97
|
| Rate for Payer: Healthscope Commercial |
$10,478.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,731.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,896.09
|
| Rate for Payer: PHP Commercial |
$9,896.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,149.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,128.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,100.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,245.36
|
| Rate for Payer: UHC Core |
$9,721.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,731.84
|
|
|
HC STENT COATED W DELIVERY SYSTEM LVL 12
|
Facility
|
OP
|
$5,463.15
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800096
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,297.50 |
| Max. Negotiated Rate |
$4,916.84 |
| Rate for Payer: Aetna Commercial |
$4,643.68
|
| Rate for Payer: Aetna Medicare |
$1,420.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,707.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,707.23
|
| Rate for Payer: BCBS Complete |
$2,185.26
|
| Rate for Payer: BCBS MAPPO |
$1,365.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,247.60
|
| Rate for Payer: BCN Commercial |
$4,247.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,365.79
|
| Rate for Payer: Cash Price |
$4,370.52
|
| Rate for Payer: Cofinity Commercial |
$4,698.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,370.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,365.79
|
| Rate for Payer: Healthscope Commercial |
$4,916.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,097.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,434.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,570.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,643.68
|
| Rate for Payer: PACE Senior Care Partners |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$1,365.79
|
| Rate for Payer: PHP Commercial |
$4,643.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,365.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,824.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,752.94
|
| Rate for Payer: Priority Health Medicare |
$1,365.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,331.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,365.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,807.57
|
| Rate for Payer: UHC Core |
$4,561.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,365.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,406.76
|
| Rate for Payer: VA VA |
$1,365.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,097.36
|
|
|
HC STENT COATED W DELIVERY SYSTEM LVL 12
|
Facility
|
IP
|
$5,463.15
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800096
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,331.98 |
| Max. Negotiated Rate |
$4,916.84 |
| Rate for Payer: Aetna Commercial |
$4,643.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,221.92
|
| Rate for Payer: BCN Commercial |
$4,221.92
|
| Rate for Payer: Cash Price |
$4,370.52
|
| Rate for Payer: Cofinity Commercial |
$4,698.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,370.52
|
| Rate for Payer: Healthscope Commercial |
$4,916.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,097.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,643.68
|
| Rate for Payer: PHP Commercial |
$4,643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,824.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,752.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,331.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,807.57
|
| Rate for Payer: UHC Core |
$4,561.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,097.36
|
|
|
HC STENT COATED W DELIVERY SYSTEM LVL 13
|
Facility
|
IP
|
$6,349.98
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,872.85 |
| Max. Negotiated Rate |
$5,714.98 |
| Rate for Payer: Aetna Commercial |
$5,397.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,907.26
|
| Rate for Payer: BCN Commercial |
$4,907.26
|
| Rate for Payer: Cash Price |
$5,079.98
|
| Rate for Payer: Cofinity Commercial |
$5,460.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,079.98
|
| Rate for Payer: Healthscope Commercial |
$5,714.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,762.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,397.48
|
| Rate for Payer: PHP Commercial |
$5,397.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,444.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,524.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,872.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,587.98
|
| Rate for Payer: UHC Core |
$5,302.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,762.48
|
|
