|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
IP
|
$16,081.87
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,808.33 |
| Max. Negotiated Rate |
$14,473.68 |
| Rate for Payer: Aetna Commercial |
$13,669.59
|
| Rate for Payer: BCBS Trust/PPO |
$12,428.07
|
| Rate for Payer: BCN Commercial |
$12,428.07
|
| Rate for Payer: Cash Price |
$12,865.50
|
| Rate for Payer: Cofinity Commercial |
$13,830.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,865.50
|
| Rate for Payer: Healthscope Commercial |
$14,473.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,061.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,669.59
|
| Rate for Payer: PHP Commercial |
$13,669.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,257.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,991.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,808.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,152.05
|
| Rate for Payer: UHC Core |
$13,428.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,061.40
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
OP
|
$16,081.87
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,819.44 |
| Max. Negotiated Rate |
$14,473.68 |
| Rate for Payer: Aetna Commercial |
$13,669.59
|
| Rate for Payer: Aetna Medicare |
$4,181.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,025.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,025.58
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$4,020.47
|
| Rate for Payer: BCBS Trust/PPO |
$12,503.65
|
| Rate for Payer: BCN Commercial |
$12,503.65
|
| Rate for Payer: BCN Medicare Advantage |
$4,020.47
|
| Rate for Payer: Cash Price |
$12,865.50
|
| Rate for Payer: Cash Price |
$12,865.50
|
| Rate for Payer: Cofinity Commercial |
$13,830.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,865.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,020.47
|
| Rate for Payer: Healthscope Commercial |
$14,473.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,061.40
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,221.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,623.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,669.59
|
| Rate for Payer: PACE Senior Care Partners |
$3,819.44
|
| Rate for Payer: PACE SWMI |
$4,020.47
|
| Rate for Payer: PHP Commercial |
$13,669.59
|
| Rate for Payer: PHP Medicare Advantage |
$4,020.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,257.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,991.23
|
| Rate for Payer: Priority Health Medicare |
$4,020.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,808.33
|
| Rate for Payer: Railroad Medicare Medicare |
$4,020.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,152.05
|
| Rate for Payer: UHC Core |
$13,428.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,020.47
|
| Rate for Payer: UHC Medicare Advantage |
$4,141.08
|
| Rate for Payer: VA VA |
$4,020.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,061.40
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
OP
|
$18,379.26
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,365.07 |
| Max. Negotiated Rate |
$16,541.33 |
| Rate for Payer: Aetna Commercial |
$15,622.37
|
| Rate for Payer: Aetna Medicare |
$4,778.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,743.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,743.52
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$4,594.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,289.87
|
| Rate for Payer: BCN Commercial |
$14,289.87
|
| Rate for Payer: BCN Medicare Advantage |
$4,594.82
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cofinity Commercial |
$15,806.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,703.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,594.82
|
| Rate for Payer: Healthscope Commercial |
$16,541.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,784.44
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,824.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,284.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,622.37
|
| Rate for Payer: PACE Senior Care Partners |
$4,365.07
|
| Rate for Payer: PACE SWMI |
$4,594.82
|
| Rate for Payer: PHP Commercial |
$15,622.37
|
| Rate for Payer: PHP Medicare Advantage |
$4,594.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,865.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,989.96
|
| Rate for Payer: Priority Health Medicare |
$4,594.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,209.51
|
| Rate for Payer: Railroad Medicare Medicare |
$4,594.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,173.75
|
| Rate for Payer: UHC Core |
$15,346.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,594.82
|
| Rate for Payer: UHC Medicare Advantage |
$4,732.66
|
| Rate for Payer: VA VA |
$4,594.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,784.44
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
IP
|
$18,379.26
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,209.51 |
| Max. Negotiated Rate |
$16,541.33 |
| Rate for Payer: Aetna Commercial |
$15,622.37
|
| Rate for Payer: BCBS Trust/PPO |
$14,203.49
|
| Rate for Payer: BCN Commercial |
$14,203.49
|
| Rate for Payer: Cash Price |
$14,703.41
|
| Rate for Payer: Cofinity Commercial |
$15,806.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,703.41
|
| Rate for Payer: Healthscope Commercial |
$16,541.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,784.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,622.37
|
| Rate for Payer: PHP Commercial |
$15,622.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,865.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,989.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,209.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,173.75
|
| Rate for Payer: UHC Core |
$15,346.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,784.44
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
IP
|
$10,408.41
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,348.09 |
| Max. Negotiated Rate |
$9,367.57 |
| Rate for Payer: Aetna Commercial |
$8,847.15
|
| Rate for Payer: BCBS Trust/PPO |
$8,043.62
|
| Rate for Payer: BCN Commercial |
$8,043.62
|
| Rate for Payer: Cash Price |
$8,326.73
|
| Rate for Payer: Cofinity Commercial |
$8,951.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,326.73
|
| Rate for Payer: Healthscope Commercial |
$9,367.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,806.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,847.15
|
| Rate for Payer: PHP Commercial |
$8,847.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,285.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,055.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,348.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,159.40
|
| Rate for Payer: UHC Core |
$8,691.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,806.31
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
OP
|
$10,408.41
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,472.00 |
| Max. Negotiated Rate |
$9,367.57 |
| Rate for Payer: Aetna Commercial |
$8,847.15
|
| Rate for Payer: Aetna Medicare |
$2,706.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,252.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,252.63
|
| Rate for Payer: BCBS Complete |
$4,163.36
|
| Rate for Payer: BCBS MAPPO |
$2,602.10
|
| Rate for Payer: BCBS Trust/PPO |
$8,092.54
|
| Rate for Payer: BCN Commercial |
$8,092.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,602.10
|
| Rate for Payer: Cash Price |
$8,326.73
|
| Rate for Payer: Cofinity Commercial |
$8,951.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,326.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,602.10
|
| Rate for Payer: Healthscope Commercial |
$9,367.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,806.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,732.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,992.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,847.15
|
| Rate for Payer: PACE Senior Care Partners |
$2,472.00
|
| Rate for Payer: PACE SWMI |
$2,602.10
|
| Rate for Payer: PHP Commercial |
$8,847.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,602.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,285.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,055.32
|
| Rate for Payer: Priority Health Medicare |
$2,602.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,348.09
|
| Rate for Payer: Railroad Medicare Medicare |
$2,602.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,159.40
|
| Rate for Payer: UHC Core |
$8,691.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,602.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,680.17
|
| Rate for Payer: VA VA |
$2,602.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,806.31
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
IP
|
$6,720.90
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,099.08 |
| Max. Negotiated Rate |
$6,048.81 |
| Rate for Payer: Aetna Commercial |
$5,712.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,193.91
|
| Rate for Payer: BCN Commercial |
$5,193.91
|
| Rate for Payer: Cash Price |
$5,376.72
|
| Rate for Payer: Cofinity Commercial |
$5,779.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,376.72
|
| Rate for Payer: Healthscope Commercial |
$6,048.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,040.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,712.76
|
| Rate for Payer: PHP Commercial |
$5,712.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,704.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,847.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,099.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,914.39
|
| Rate for Payer: UHC Core |
$5,611.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,040.68
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
OP
|
$6,720.90
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,596.21 |
| Max. Negotiated Rate |
$6,048.81 |
| Rate for Payer: Aetna Commercial |
$5,712.76
|
| Rate for Payer: Aetna Medicare |
$1,747.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,100.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,100.28
|
| Rate for Payer: BCBS Complete |
$2,688.36
|
| Rate for Payer: BCBS MAPPO |
$1,680.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,225.50
|
| Rate for Payer: BCN Commercial |
$5,225.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,680.22
|
| Rate for Payer: Cash Price |
$5,376.72
|
| Rate for Payer: Cofinity Commercial |
$5,779.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,376.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,680.22
|
| Rate for Payer: Healthscope Commercial |
$6,048.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,040.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,764.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,932.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,712.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,596.21
|
| Rate for Payer: PACE SWMI |
$1,680.22
|
| Rate for Payer: PHP Commercial |
$5,712.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,680.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,704.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,847.18
|
| Rate for Payer: Priority Health Medicare |
$1,680.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,099.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,680.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,914.39
|
| Rate for Payer: UHC Core |
$5,611.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,680.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,730.63
|
| Rate for Payer: VA VA |
$1,680.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,040.68
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
OP
|
$24,183.90
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,743.68 |
| Max. Negotiated Rate |
$21,765.51 |
| Rate for Payer: Aetna Commercial |
$20,556.32
|
| Rate for Payer: Aetna Medicare |
$6,287.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,557.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,557.47
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$6,045.98
|
| Rate for Payer: BCBS Trust/PPO |
$18,802.98
|
| Rate for Payer: BCN Commercial |
$18,802.98
|
| Rate for Payer: BCN Medicare Advantage |
$6,045.98
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cofinity Commercial |
$20,798.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,347.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,045.98
|
| Rate for Payer: Healthscope Commercial |
$21,765.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,137.92
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,348.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,952.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,556.32
|
| Rate for Payer: PACE Senior Care Partners |
$5,743.68
|
| Rate for Payer: PACE SWMI |
$6,045.98
|
| Rate for Payer: PHP Commercial |
$20,556.32
|
| Rate for Payer: PHP Medicare Advantage |
$6,045.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,928.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,039.99
|
| Rate for Payer: Priority Health Medicare |
$6,045.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,749.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6,045.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,281.83
|
| Rate for Payer: UHC Core |
$20,193.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,045.98
|
| Rate for Payer: UHC Medicare Advantage |
$6,227.35
|
| Rate for Payer: VA VA |
$6,045.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,137.92
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
IP
|
$24,183.90
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,749.76 |
| Max. Negotiated Rate |
$21,765.51 |
| Rate for Payer: Aetna Commercial |
$20,556.32
|
| Rate for Payer: BCBS Trust/PPO |
$18,689.32
|
| Rate for Payer: BCN Commercial |
$18,689.32
|
| Rate for Payer: Cash Price |
$19,347.12
|
| Rate for Payer: Cofinity Commercial |
$20,798.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,347.12
|
| Rate for Payer: Healthscope Commercial |
$21,765.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,137.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20,556.32
|
| Rate for Payer: PHP Commercial |
$20,556.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,928.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,039.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,749.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,281.83
|
| Rate for Payer: UHC Core |
$20,193.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,137.92
|
|
|
HC STIZ MARKER
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$51.23 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Aetna Commercial |
$71.40
|
| Rate for Payer: BCBS Trust/PPO |
$64.92
|
| Rate for Payer: BCN Commercial |
$64.92
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Healthscope Commercial |
$75.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: PHP Commercial |
$71.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.92
|
| Rate for Payer: UHC Core |
$70.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.00
|
|
|
HC STIZ MARKER
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Aetna Commercial |
$71.40
|
| Rate for Payer: Aetna Medicare |
$21.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.25
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$21.00
|
| Rate for Payer: BCBS Trust/PPO |
$65.31
|
| Rate for Payer: BCN Commercial |
$65.31
|
| Rate for Payer: BCN Medicare Advantage |
$21.00
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.00
|
| Rate for Payer: Healthscope Commercial |
$75.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: PACE Senior Care Partners |
$19.95
|
| Rate for Payer: PACE SWMI |
$21.00
|
| Rate for Payer: PHP Commercial |
$71.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.08
|
| Rate for Payer: Priority Health Medicare |
$21.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.23
|
| Rate for Payer: Railroad Medicare Medicare |
$21.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.92
|
| Rate for Payer: UHC Core |
$70.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.00
|
| Rate for Payer: UHC Medicare Advantage |
$21.63
|
| Rate for Payer: VA VA |
$21.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.00
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$27,540.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$16,796.65 |
| Max. Negotiated Rate |
$24,786.00 |
| Rate for Payer: Aetna Commercial |
$23,409.00
|
| Rate for Payer: BCBS Trust/PPO |
$21,282.91
|
| Rate for Payer: BCN Commercial |
$21,282.91
|
| Rate for Payer: Cash Price |
$22,032.00
|
| Rate for Payer: Cofinity Commercial |
$23,684.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,032.00
|
| Rate for Payer: Healthscope Commercial |
$24,786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,655.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,409.00
|
| Rate for Payer: PHP Commercial |
$23,409.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,278.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,959.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,796.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,235.20
|
| Rate for Payer: UHC Core |
$22,995.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,655.00
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$27,540.00
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,540.75 |
| Max. Negotiated Rate |
$24,786.00 |
| Rate for Payer: Aetna Commercial |
$23,409.00
|
| Rate for Payer: Aetna Medicare |
$7,160.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,606.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,606.25
|
| Rate for Payer: BCBS Complete |
$11,016.00
|
| Rate for Payer: BCBS MAPPO |
$6,885.00
|
| Rate for Payer: BCBS Trust/PPO |
$21,412.35
|
| Rate for Payer: BCN Commercial |
$21,412.35
|
| Rate for Payer: BCN Medicare Advantage |
$6,885.00
|
| Rate for Payer: Cash Price |
$22,032.00
|
| Rate for Payer: Cofinity Commercial |
$23,684.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,032.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,885.00
|
| Rate for Payer: Healthscope Commercial |
$24,786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,655.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,229.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,917.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,409.00
|
| Rate for Payer: PACE Senior Care Partners |
$6,540.75
|
| Rate for Payer: PACE SWMI |
$6,885.00
|
| Rate for Payer: PHP Commercial |
$23,409.00
|
| Rate for Payer: PHP Medicare Advantage |
$6,885.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,278.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,959.80
|
| Rate for Payer: Priority Health Medicare |
$6,885.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,796.65
|
| Rate for Payer: Railroad Medicare Medicare |
$6,885.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,235.20
|
| Rate for Payer: UHC Core |
$22,995.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,885.00
|
| Rate for Payer: UHC Medicare Advantage |
$7,091.55
|
| Rate for Payer: VA VA |
$6,885.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,655.00
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,712.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,356.60 |
| Max. Negotiated Rate |
$5,140.80 |
| Rate for Payer: Aetna Commercial |
$4,855.20
|
| Rate for Payer: Aetna Medicare |
$1,485.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.00
|
| Rate for Payer: BCBS Complete |
$2,284.80
|
| Rate for Payer: BCBS MAPPO |
$1,428.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,441.08
|
| Rate for Payer: BCN Commercial |
$4,441.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.00
|
| Rate for Payer: Cash Price |
$4,569.60
|
| Rate for Payer: Cofinity Commercial |
$4,912.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.00
|
| Rate for Payer: Healthscope Commercial |
$5,140.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,499.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,356.60
|
| Rate for Payer: PACE SWMI |
$1,428.00
|
| Rate for Payer: PHP Commercial |
$4,855.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,969.44
|
| Rate for Payer: Priority Health Medicare |
$1,428.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,483.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.56
|
| Rate for Payer: UHC Core |
$4,769.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,470.84
|
| Rate for Payer: VA VA |
$1,428.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.00
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
IP
|
$5,712.00
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,483.75 |
| Max. Negotiated Rate |
$5,140.80 |
| Rate for Payer: Aetna Commercial |
$4,855.20
|
| Rate for Payer: BCBS Trust/PPO |
$4,414.23
|
| Rate for Payer: BCN Commercial |
$4,414.23
|
| Rate for Payer: Cash Price |
$4,569.60
|
| Rate for Payer: Cofinity Commercial |
$4,912.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.60
|
| Rate for Payer: Healthscope Commercial |
$5,140.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.20
|
| Rate for Payer: PHP Commercial |
$4,855.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,969.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,483.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.56
|
| Rate for Payer: UHC Core |
$4,769.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.00
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
IP
|
$9,180.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,598.88 |
| Max. Negotiated Rate |
$8,262.00 |
| Rate for Payer: Aetna Commercial |
$7,803.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,094.30
|
| Rate for Payer: BCN Commercial |
$7,094.30
|
| Rate for Payer: Cash Price |
$7,344.00
|
| Rate for Payer: Cofinity Commercial |
$7,894.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,344.00
|
| Rate for Payer: Healthscope Commercial |
$8,262.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,885.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,803.00
|
| Rate for Payer: PHP Commercial |
$7,803.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,426.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,986.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,598.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,078.40
|
| Rate for Payer: UHC Core |
$7,665.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,885.00
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
OP
|
$9,180.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,180.25 |
| Max. Negotiated Rate |
$8,262.00 |
| Rate for Payer: Aetna Commercial |
$7,803.00
|
| Rate for Payer: Aetna Medicare |
$2,386.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,868.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,868.75
|
| Rate for Payer: BCBS Complete |
$3,672.00
|
| Rate for Payer: BCBS MAPPO |
$2,295.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,137.45
|
| Rate for Payer: BCN Commercial |
$7,137.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,295.00
|
| Rate for Payer: Cash Price |
$7,344.00
|
| Rate for Payer: Cofinity Commercial |
$7,894.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,295.00
|
| Rate for Payer: Healthscope Commercial |
$8,262.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,885.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,409.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,639.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,803.00
|
| Rate for Payer: PACE Senior Care Partners |
$2,180.25
|
| Rate for Payer: PACE SWMI |
$2,295.00
|
| Rate for Payer: PHP Commercial |
$7,803.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,295.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,426.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,986.60
|
| Rate for Payer: Priority Health Medicare |
$2,295.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,598.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,295.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,078.40
|
| Rate for Payer: UHC Core |
$7,665.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,295.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,363.85
|
| Rate for Payer: VA VA |
$2,295.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,885.00
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
OP
|
$20,808.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,941.90 |
| Max. Negotiated Rate |
$18,727.20 |
| Rate for Payer: Aetna Commercial |
$17,686.80
|
| Rate for Payer: Aetna Medicare |
$5,410.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,502.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,502.50
|
| Rate for Payer: BCBS Complete |
$8,323.20
|
| Rate for Payer: BCBS MAPPO |
$5,202.00
|
| Rate for Payer: BCBS Trust/PPO |
$16,178.22
|
| Rate for Payer: BCN Commercial |
$16,178.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,202.00
|
| Rate for Payer: Cash Price |
$16,646.40
|
| Rate for Payer: Cofinity Commercial |
$17,894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,646.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,202.00
|
| Rate for Payer: Healthscope Commercial |
$18,727.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,606.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,462.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,982.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,686.80
|
| Rate for Payer: PACE Senior Care Partners |
$4,941.90
|
| Rate for Payer: PACE SWMI |
$5,202.00
|
| Rate for Payer: PHP Commercial |
$17,686.80
|
| Rate for Payer: PHP Medicare Advantage |
$5,202.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,565.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,102.96
|
| Rate for Payer: Priority Health Medicare |
$5,202.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,690.80
|
| Rate for Payer: Railroad Medicare Medicare |
$5,202.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,311.04
|
| Rate for Payer: UHC Core |
$17,374.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,202.00
|
| Rate for Payer: UHC Medicare Advantage |
$5,358.06
|
| Rate for Payer: VA VA |
$5,202.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,606.00
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
IP
|
$20,808.00
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,690.80 |
| Max. Negotiated Rate |
$18,727.20 |
| Rate for Payer: Aetna Commercial |
$17,686.80
|
| Rate for Payer: BCBS Trust/PPO |
$16,080.42
|
| Rate for Payer: BCN Commercial |
$16,080.42
|
| Rate for Payer: Cash Price |
$16,646.40
|
| Rate for Payer: Cofinity Commercial |
$17,894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,646.40
|
| Rate for Payer: Healthscope Commercial |
$18,727.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,606.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17,686.80
|
| Rate for Payer: PHP Commercial |
$17,686.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,565.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,102.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,690.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,311.04
|
| Rate for Payer: UHC Core |
$17,374.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,606.00
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
IP
|
$13,790.40
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,410.76 |
| Max. Negotiated Rate |
$12,411.36 |
| Rate for Payer: Aetna Commercial |
$11,721.84
|
| Rate for Payer: BCBS Trust/PPO |
$10,657.22
|
| Rate for Payer: BCN Commercial |
$10,657.22
|
| Rate for Payer: Cash Price |
$11,032.32
|
| Rate for Payer: Cofinity Commercial |
$11,859.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,032.32
|
| Rate for Payer: Healthscope Commercial |
$12,411.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,342.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,721.84
|
| Rate for Payer: PHP Commercial |
$11,721.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,653.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,997.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,410.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,135.55
|
| Rate for Payer: UHC Core |
$11,514.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,342.80
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
OP
|
$13,790.40
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,275.22 |
| Max. Negotiated Rate |
$12,411.36 |
| Rate for Payer: Aetna Commercial |
$11,721.84
|
| Rate for Payer: Aetna Medicare |
$3,585.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,309.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,309.50
|
| Rate for Payer: BCBS Complete |
$5,516.16
|
| Rate for Payer: BCBS MAPPO |
$3,447.60
|
| Rate for Payer: BCBS Trust/PPO |
$10,722.04
|
| Rate for Payer: BCN Commercial |
$10,722.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,447.60
|
| Rate for Payer: Cash Price |
$11,032.32
|
| Rate for Payer: Cofinity Commercial |
$11,859.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,032.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,447.60
|
| Rate for Payer: Healthscope Commercial |
$12,411.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,342.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,619.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,964.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,721.84
|
| Rate for Payer: PACE Senior Care Partners |
$3,275.22
|
| Rate for Payer: PACE SWMI |
$3,447.60
|
| Rate for Payer: PHP Commercial |
$11,721.84
|
| Rate for Payer: PHP Medicare Advantage |
$3,447.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,653.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,997.65
|
| Rate for Payer: Priority Health Medicare |
$3,447.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,410.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3,447.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,135.55
|
| Rate for Payer: UHC Core |
$11,514.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,447.60
|
| Rate for Payer: UHC Medicare Advantage |
$3,551.03
|
| Rate for Payer: VA VA |
$3,447.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,342.80
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
IP
|
$7,038.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,292.48 |
| Max. Negotiated Rate |
$6,334.20 |
| Rate for Payer: Aetna Commercial |
$5,982.30
|
| Rate for Payer: BCBS Trust/PPO |
$5,438.97
|
| Rate for Payer: BCN Commercial |
$5,438.97
|
| Rate for Payer: Cash Price |
$5,630.40
|
| Rate for Payer: Cofinity Commercial |
$6,052.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,630.40
|
| Rate for Payer: Healthscope Commercial |
$6,334.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,278.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,982.30
|
| Rate for Payer: PHP Commercial |
$5,982.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,926.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,123.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,292.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,193.44
|
| Rate for Payer: UHC Core |
$5,876.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,278.50
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
OP
|
$7,038.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,671.52 |
| Max. Negotiated Rate |
$6,334.20 |
| Rate for Payer: Aetna Commercial |
$5,982.30
|
| Rate for Payer: Aetna Medicare |
$1,829.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,199.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,199.38
|
| Rate for Payer: BCBS Complete |
$2,815.20
|
| Rate for Payer: BCBS MAPPO |
$1,759.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.04
|
| Rate for Payer: BCN Commercial |
$5,472.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.50
|
| Rate for Payer: Cash Price |
$5,630.40
|
| Rate for Payer: Cofinity Commercial |
$6,052.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.50
|
| Rate for Payer: Healthscope Commercial |
$6,334.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,278.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,847.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,023.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,982.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,671.52
|
| Rate for Payer: PACE SWMI |
$1,759.50
|
| Rate for Payer: PHP Commercial |
$5,982.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,926.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,123.06
|
| Rate for Payer: Priority Health Medicare |
$1,759.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,292.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,759.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,193.44
|
| Rate for Payer: UHC Core |
$5,876.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,759.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,812.28
|
| Rate for Payer: VA VA |
$1,759.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,278.50
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,004.63
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,901.10 |
| Max. Negotiated Rate |
$7,204.17 |
| Rate for Payer: Aetna Commercial |
$6,803.94
|
| Rate for Payer: Aetna Medicare |
$2,081.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,501.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,501.45
|
| Rate for Payer: BCBS Complete |
$3,201.85
|
| Rate for Payer: BCBS MAPPO |
$2,001.16
|
| Rate for Payer: BCBS Trust/PPO |
$6,223.60
|
| Rate for Payer: BCN Commercial |
$6,223.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,001.16
|
| Rate for Payer: Cash Price |
$6,403.70
|
| Rate for Payer: Cofinity Commercial |
$6,883.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,403.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,001.16
|
| Rate for Payer: Healthscope Commercial |
$7,204.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,003.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,101.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,301.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,803.94
|
| Rate for Payer: PACE Senior Care Partners |
$1,901.10
|
| Rate for Payer: PACE SWMI |
$2,001.16
|
| Rate for Payer: PHP Commercial |
$6,803.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,001.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,603.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,964.03
|
| Rate for Payer: Priority Health Medicare |
$2,001.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,882.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,001.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,044.07
|
| Rate for Payer: UHC Core |
$6,683.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,001.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,061.19
|
| Rate for Payer: VA VA |
$2,001.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,003.47
|
|
