|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$101.90 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$111.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.08
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$107.26
|
| Rate for Payer: BCBS Trust/PPO |
$333.59
|
| Rate for Payer: BCN Commercial |
$333.59
|
| Rate for Payer: BCN Medicare Advantage |
$107.26
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.26
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Senior Care Partners |
$101.90
|
| Rate for Payer: PACE SWMI |
$107.26
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$107.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Medicare |
$107.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: Railroad Medicare Medicare |
$107.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.26
|
| Rate for Payer: UHC Medicare Advantage |
$110.48
|
| Rate for Payer: VA VA |
$107.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$261.68 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: BCBS Trust/PPO |
$331.57
|
| Rate for Payer: BCN Commercial |
$331.57
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$613.96
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$374.45 |
| Max. Negotiated Rate |
$552.56 |
| Rate for Payer: Aetna Commercial |
$521.87
|
| Rate for Payer: BCBS Trust/PPO |
$474.47
|
| Rate for Payer: BCN Commercial |
$474.47
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cofinity Commercial |
$528.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.17
|
| Rate for Payer: Healthscope Commercial |
$552.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.87
|
| Rate for Payer: PHP Commercial |
$521.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.28
|
| Rate for Payer: UHC Core |
$512.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.47
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$613.96
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$145.82 |
| Max. Negotiated Rate |
$720.16 |
| Rate for Payer: Aetna Commercial |
$521.87
|
| Rate for Payer: Aetna Medicare |
$159.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.86
|
| Rate for Payer: BCBS Complete |
$720.16
|
| Rate for Payer: BCBS MAPPO |
$153.49
|
| Rate for Payer: BCBS Trust/PPO |
$477.35
|
| Rate for Payer: BCN Commercial |
$477.35
|
| Rate for Payer: BCN Medicare Advantage |
$153.49
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cash Price |
$491.17
|
| Rate for Payer: Cofinity Commercial |
$528.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.49
|
| Rate for Payer: Healthscope Commercial |
$552.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.47
|
| Rate for Payer: Mclaren Medicaid |
$685.87
|
| Rate for Payer: Meridian Medicaid |
$720.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$521.87
|
| Rate for Payer: PACE Senior Care Partners |
$145.82
|
| Rate for Payer: PACE SWMI |
$153.49
|
| Rate for Payer: PHP Commercial |
$521.87
|
| Rate for Payer: PHP Medicare Advantage |
$153.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$429.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.15
|
| Rate for Payer: Priority Health Medicare |
$153.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.45
|
| Rate for Payer: Railroad Medicare Medicare |
$153.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.28
|
| Rate for Payer: UHC Core |
$512.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.49
|
| Rate for Payer: UHC Medicare Advantage |
$158.09
|
| Rate for Payer: VA VA |
$153.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.47
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,173.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$278.59 |
| Max. Negotiated Rate |
$1,055.70 |
| Rate for Payer: Aetna Commercial |
$997.05
|
| Rate for Payer: Aetna Medicare |
$304.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$366.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$366.56
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$293.25
|
| Rate for Payer: BCBS Trust/PPO |
$912.01
|
| Rate for Payer: BCN Commercial |
$912.01
|
| Rate for Payer: BCN Medicare Advantage |
$293.25
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$1,008.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$938.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.25
|
| Rate for Payer: Healthscope Commercial |
$1,055.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$879.75
|
| Rate for Payer: Mclaren Medicaid |
$284.77
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.05
|
| Rate for Payer: PACE Senior Care Partners |
$278.59
|
| Rate for Payer: PACE SWMI |
$293.25
|
| Rate for Payer: PHP Commercial |
$997.05
|
| Rate for Payer: PHP Medicare Advantage |
$293.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.51
|
| Rate for Payer: Priority Health Medicare |
$293.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$715.41
|
| Rate for Payer: Railroad Medicare Medicare |
$293.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,032.24
|
| Rate for Payer: UHC Core |
$979.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.25
|
| Rate for Payer: UHC Medicare Advantage |
$302.05
|
| Rate for Payer: VA VA |
$293.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$879.75
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,173.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$715.41 |
| Max. Negotiated Rate |
$1,055.70 |
| Rate for Payer: Aetna Commercial |
$997.05
|
| Rate for Payer: BCBS Trust/PPO |
$906.49
|
| Rate for Payer: BCN Commercial |
$906.49
|
| Rate for Payer: Cash Price |
$938.40
|
| Rate for Payer: Cofinity Commercial |
$1,008.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$938.40
|
| Rate for Payer: Healthscope Commercial |
$1,055.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$879.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.05
|
| Rate for Payer: PHP Commercial |
$997.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$715.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,032.24
|
| Rate for Payer: UHC Core |
$979.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$879.75
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$619.65
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$377.92 |
| Max. Negotiated Rate |
$557.68 |
| Rate for Payer: Aetna Commercial |
$526.70
|
| Rate for Payer: BCBS Trust/PPO |
$478.87
|
| Rate for Payer: BCN Commercial |
$478.87
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cofinity Commercial |
$532.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.72
|
| Rate for Payer: Healthscope Commercial |
$557.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.70
|
| Rate for Payer: PHP Commercial |
$526.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.29
|
| Rate for Payer: UHC Core |
$517.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.74
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$619.65
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$147.17 |
| Max. Negotiated Rate |
$557.68 |
| Rate for Payer: Aetna Commercial |
$526.70
|
| Rate for Payer: Aetna Medicare |
$161.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.64
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$154.91
|
| Rate for Payer: BCBS Trust/PPO |
$481.78
|
| Rate for Payer: BCN Commercial |
$481.78
|
| Rate for Payer: BCN Medicare Advantage |
$154.91
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cash Price |
$495.72
|
| Rate for Payer: Cofinity Commercial |
$532.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.91
|
| Rate for Payer: Healthscope Commercial |
$557.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.74
|
| Rate for Payer: Mclaren Medicaid |
$284.77
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$178.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.70
|
| Rate for Payer: PACE Senior Care Partners |
$147.17
|
| Rate for Payer: PACE SWMI |
$154.91
|
| Rate for Payer: PHP Commercial |
$526.70
|
| Rate for Payer: PHP Medicare Advantage |
$154.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$539.10
|
| Rate for Payer: Priority Health Medicare |
$154.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.92
|
| Rate for Payer: Railroad Medicare Medicare |
$154.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.29
|
| Rate for Payer: UHC Core |
$517.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.91
|
| Rate for Payer: UHC Medicare Advantage |
$159.56
|
| Rate for Payer: VA VA |
$154.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.74
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,106.01
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$737.68 |
| Max. Negotiated Rate |
$2,795.41 |
| Rate for Payer: Aetna Commercial |
$2,640.11
|
| Rate for Payer: Aetna Medicare |
$807.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$970.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$970.63
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$776.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.92
|
| Rate for Payer: BCN Commercial |
$2,414.92
|
| Rate for Payer: BCN Medicare Advantage |
$776.50
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cofinity Commercial |
$2,671.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,484.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$776.50
|
| Rate for Payer: Healthscope Commercial |
$2,795.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,329.51
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$815.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$892.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,640.11
|
| Rate for Payer: PACE Senior Care Partners |
$737.68
|
| Rate for Payer: PACE SWMI |
$776.50
|
| Rate for Payer: PHP Commercial |
$2,640.11
|
| Rate for Payer: PHP Medicare Advantage |
$776.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,174.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,702.23
|
| Rate for Payer: Priority Health Medicare |
$776.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,894.36
|
| Rate for Payer: Railroad Medicare Medicare |
$776.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,733.29
|
| Rate for Payer: UHC Core |
$2,593.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$776.50
|
| Rate for Payer: UHC Medicare Advantage |
$799.80
|
| Rate for Payer: VA VA |
$776.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,329.51
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
IP
|
$3,106.01
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,894.36 |
| Max. Negotiated Rate |
$2,795.41 |
| Rate for Payer: Aetna Commercial |
$2,640.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.32
|
| Rate for Payer: BCN Commercial |
$2,400.32
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cofinity Commercial |
$2,671.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,484.81
|
| Rate for Payer: Healthscope Commercial |
$2,795.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,329.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,640.11
|
| Rate for Payer: PHP Commercial |
$2,640.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,174.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,702.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,894.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,733.29
|
| Rate for Payer: UHC Core |
$2,593.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,329.51
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,130.20
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,455.92 |
| Max. Negotiated Rate |
$5,517.18 |
| Rate for Payer: Aetna Commercial |
$5,210.67
|
| Rate for Payer: Aetna Medicare |
$1,593.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,915.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,915.69
|
| Rate for Payer: BCBS Complete |
$3,564.05
|
| Rate for Payer: BCBS MAPPO |
$1,532.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,766.23
|
| Rate for Payer: BCN Commercial |
$4,766.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,532.55
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cofinity Commercial |
$5,271.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,904.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,532.55
|
| Rate for Payer: Healthscope Commercial |
$5,517.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,597.65
|
| Rate for Payer: Mclaren Medicaid |
$3,394.34
|
| Rate for Payer: Meridian Medicaid |
$3,564.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,609.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,210.67
|
| Rate for Payer: PACE Senior Care Partners |
$1,455.92
|
| Rate for Payer: PACE SWMI |
$1,532.55
|
| Rate for Payer: PHP Commercial |
$5,210.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,532.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,394.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,291.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,333.27
|
| Rate for Payer: Priority Health Medicare |
$1,532.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,738.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,532.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,394.58
|
| Rate for Payer: UHC Core |
$5,118.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,532.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,578.53
|
| Rate for Payer: VA VA |
$1,532.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,597.65
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,130.20
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,738.81 |
| Max. Negotiated Rate |
$5,517.18 |
| Rate for Payer: Aetna Commercial |
$5,210.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,737.42
|
| Rate for Payer: BCN Commercial |
$4,737.42
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cofinity Commercial |
$5,271.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,904.16
|
| Rate for Payer: Healthscope Commercial |
$5,517.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,597.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,210.67
|
| Rate for Payer: PHP Commercial |
$5,210.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,291.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,333.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,738.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,394.58
|
| Rate for Payer: UHC Core |
$5,118.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,597.65
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,621.13
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,208.53 |
| Max. Negotiated Rate |
$3,259.02 |
| Rate for Payer: Aetna Commercial |
$3,077.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,798.41
|
| Rate for Payer: BCN Commercial |
$2,798.41
|
| Rate for Payer: Cash Price |
$2,896.90
|
| Rate for Payer: Cofinity Commercial |
$3,114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,896.90
|
| Rate for Payer: Healthscope Commercial |
$3,259.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,715.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,077.96
|
| Rate for Payer: PHP Commercial |
$3,077.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,150.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,208.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,186.59
|
| Rate for Payer: UHC Core |
$3,023.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,715.85
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,621.13
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$860.02 |
| Max. Negotiated Rate |
$3,259.02 |
| Rate for Payer: Aetna Commercial |
$3,077.96
|
| Rate for Payer: Aetna Medicare |
$941.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,131.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,131.60
|
| Rate for Payer: BCBS Complete |
$1,448.45
|
| Rate for Payer: BCBS MAPPO |
$905.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,815.43
|
| Rate for Payer: BCN Commercial |
$2,815.43
|
| Rate for Payer: BCN Medicare Advantage |
$905.28
|
| Rate for Payer: Cash Price |
$2,896.90
|
| Rate for Payer: Cofinity Commercial |
$3,114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,896.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$905.28
|
| Rate for Payer: Healthscope Commercial |
$3,259.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,715.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$950.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,041.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,077.96
|
| Rate for Payer: PACE Senior Care Partners |
$860.02
|
| Rate for Payer: PACE SWMI |
$905.28
|
| Rate for Payer: PHP Commercial |
$3,077.96
|
| Rate for Payer: PHP Medicare Advantage |
$905.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,150.38
|
| Rate for Payer: Priority Health Medicare |
$905.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,208.53
|
| Rate for Payer: Railroad Medicare Medicare |
$905.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,186.59
|
| Rate for Payer: UHC Core |
$3,023.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$905.28
|
| Rate for Payer: UHC Medicare Advantage |
$932.44
|
| Rate for Payer: VA VA |
$905.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,715.85
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,826.40
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,146.27 |
| Max. Negotiated Rate |
$4,343.76 |
| Rate for Payer: Aetna Commercial |
$4,102.44
|
| Rate for Payer: Aetna Medicare |
$1,254.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,508.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,508.25
|
| Rate for Payer: BCBS Complete |
$1,930.56
|
| Rate for Payer: BCBS MAPPO |
$1,206.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,752.53
|
| Rate for Payer: BCN Commercial |
$3,752.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,206.60
|
| Rate for Payer: Cash Price |
$3,861.12
|
| Rate for Payer: Cofinity Commercial |
$4,150.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,206.60
|
| Rate for Payer: Healthscope Commercial |
$4,343.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,266.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,387.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,102.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,146.27
|
| Rate for Payer: PACE SWMI |
$1,206.60
|
| Rate for Payer: PHP Commercial |
$4,102.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,206.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,378.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,198.97
|
| Rate for Payer: Priority Health Medicare |
$1,206.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,943.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,206.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,247.23
|
| Rate for Payer: UHC Core |
$4,030.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,206.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,242.80
|
| Rate for Payer: VA VA |
$1,206.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.80
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,826.40
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,943.62 |
| Max. Negotiated Rate |
$4,343.76 |
| Rate for Payer: Aetna Commercial |
$4,102.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,729.84
|
| Rate for Payer: BCN Commercial |
$3,729.84
|
| Rate for Payer: Cash Price |
$3,861.12
|
| Rate for Payer: Cofinity Commercial |
$4,150.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.12
|
| Rate for Payer: Healthscope Commercial |
$4,343.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,102.44
|
| Rate for Payer: PHP Commercial |
$4,102.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,378.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,198.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,943.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,247.23
|
| Rate for Payer: UHC Core |
$4,030.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.80
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$886.66
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$540.77 |
| Max. Negotiated Rate |
$797.99 |
| Rate for Payer: Aetna Commercial |
$753.66
|
| Rate for Payer: BCBS Trust/PPO |
$685.21
|
| Rate for Payer: BCN Commercial |
$685.21
|
| Rate for Payer: Cash Price |
$709.33
|
| Rate for Payer: Cofinity Commercial |
$762.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.33
|
| Rate for Payer: Healthscope Commercial |
$797.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.66
|
| Rate for Payer: PHP Commercial |
$753.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.26
|
| Rate for Payer: UHC Core |
$740.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.00
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$886.66
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$210.58 |
| Max. Negotiated Rate |
$797.99 |
| Rate for Payer: Aetna Commercial |
$753.66
|
| Rate for Payer: Aetna Medicare |
$230.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$277.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$277.08
|
| Rate for Payer: BCBS Complete |
$354.66
|
| Rate for Payer: BCBS MAPPO |
$221.66
|
| Rate for Payer: BCBS Trust/PPO |
$689.38
|
| Rate for Payer: BCN Commercial |
$689.38
|
| Rate for Payer: BCN Medicare Advantage |
$221.66
|
| Rate for Payer: Cash Price |
$709.33
|
| Rate for Payer: Cofinity Commercial |
$762.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.66
|
| Rate for Payer: Healthscope Commercial |
$797.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.66
|
| Rate for Payer: PACE Senior Care Partners |
$210.58
|
| Rate for Payer: PACE SWMI |
$221.66
|
| Rate for Payer: PHP Commercial |
$753.66
|
| Rate for Payer: PHP Medicare Advantage |
$221.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$771.39
|
| Rate for Payer: Priority Health Medicare |
$221.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.77
|
| Rate for Payer: Railroad Medicare Medicare |
$221.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.26
|
| Rate for Payer: UHC Core |
$740.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.66
|
| Rate for Payer: UHC Medicare Advantage |
$228.31
|
| Rate for Payer: VA VA |
$221.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.00
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.38
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.58
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$382.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$393.98
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,170.96
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$714.17 |
| Max. Negotiated Rate |
$1,053.86 |
| Rate for Payer: Aetna Commercial |
$995.32
|
| Rate for Payer: BCBS Trust/PPO |
$904.92
|
| Rate for Payer: BCN Commercial |
$904.92
|
| Rate for Payer: Cash Price |
$936.77
|
| Rate for Payer: Cofinity Commercial |
$1,007.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.77
|
| Rate for Payer: Healthscope Commercial |
$1,053.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$878.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$995.32
|
| Rate for Payer: PHP Commercial |
$995.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$714.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,030.44
|
| Rate for Payer: UHC Core |
$977.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$878.22
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,170.96
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.10 |
| Max. Negotiated Rate |
$1,053.86 |
| Rate for Payer: Aetna Commercial |
$995.32
|
| Rate for Payer: Aetna Medicare |
$304.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$365.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$365.92
|
| Rate for Payer: BCBS Complete |
$468.38
|
| Rate for Payer: BCBS MAPPO |
$292.74
|
| Rate for Payer: BCBS Trust/PPO |
$910.42
|
| Rate for Payer: BCN Commercial |
$910.42
|
| Rate for Payer: BCN Medicare Advantage |
$292.74
|
| Rate for Payer: Cash Price |
$936.77
|
| Rate for Payer: Cofinity Commercial |
$1,007.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.74
|
| Rate for Payer: Healthscope Commercial |
$1,053.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$878.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$336.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$995.32
|
| Rate for Payer: PACE Senior Care Partners |
$278.10
|
| Rate for Payer: PACE SWMI |
$292.74
|
| Rate for Payer: PHP Commercial |
$995.32
|
| Rate for Payer: PHP Medicare Advantage |
$292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.74
|
| Rate for Payer: Priority Health Medicare |
$292.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$714.17
|
| Rate for Payer: Railroad Medicare Medicare |
$292.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,030.44
|
| Rate for Payer: UHC Core |
$977.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.74
|
| Rate for Payer: UHC Medicare Advantage |
$301.52
|
| Rate for Payer: VA VA |
$292.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$878.22
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,807.00
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,931.79 |
| Max. Negotiated Rate |
$4,326.30 |
| Rate for Payer: Aetna Commercial |
$4,085.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,714.85
|
| Rate for Payer: BCN Commercial |
$3,714.85
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cofinity Commercial |
$4,134.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,845.60
|
| Rate for Payer: Healthscope Commercial |
$4,326.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,605.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,085.95
|
| Rate for Payer: PHP Commercial |
$4,085.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,364.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,182.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,931.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,230.16
|
| Rate for Payer: UHC Core |
$4,013.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,605.25
|
|
