|
HC PERFUSION OPEN HEART
|
Facility
|
OP
|
$6,656.19
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,173.49 |
| Max. Negotiated Rate |
$5,990.57 |
| Rate for Payer: Aetna Commercial |
$5,657.76
|
| Rate for Payer: Aetna Medicare |
$1,730.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,080.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,080.06
|
| Rate for Payer: BCBS Complete |
$1,232.06
|
| Rate for Payer: BCBS MAPPO |
$1,664.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.05
|
| Rate for Payer: BCN Commercial |
$5,472.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,664.05
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$5,724.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,664.05
|
| Rate for Payer: Healthscope Commercial |
$5,990.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.14
|
| Rate for Payer: Mclaren Medicaid |
$1,173.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,747.25
|
| Rate for Payer: Meridian Medicaid |
$1,232.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,913.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,830.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,580.85
|
| Rate for Payer: PACE SWMI |
$1,664.05
|
| Rate for Payer: PHP Commercial |
$5,657.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,664.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,173.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,790.89
|
| Rate for Payer: Priority Health Medicare |
$1,680.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,632.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,664.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,857.45
|
| Rate for Payer: UHC Core |
$5,557.92
|
| Rate for Payer: UHC Exchange |
$1,664.05
|
| Rate for Payer: UHC Medicaid |
$1,173.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,664.05
|
| Rate for Payer: UHCCP Medicaid |
$1,173.49
|
| Rate for Payer: VA VA |
$1,664.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.14
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,596.18
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,806.94 |
| Max. Negotiated Rate |
$2,336.56 |
| Rate for Payer: Aetna Commercial |
$2,206.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,144.19
|
| Rate for Payer: BCN Commercial |
$2,144.19
|
| Rate for Payer: Cash Price |
$2,076.94
|
| Rate for Payer: Cofinity Commercial |
$2,232.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,076.94
|
| Rate for Payer: Healthscope Commercial |
$2,336.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.75
|
| Rate for Payer: Nomi Health Commercial |
$2,128.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.13
|
| Rate for Payer: PHP Commercial |
$2,206.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,258.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,806.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,284.64
|
| Rate for Payer: UHC Core |
$2,167.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.13
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
OP
|
$2,596.18
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$457.71 |
| Max. Negotiated Rate |
$2,336.56 |
| Rate for Payer: Aetna Commercial |
$2,206.75
|
| Rate for Payer: Aetna Medicare |
$675.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$811.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$811.31
|
| Rate for Payer: BCBS Complete |
$480.55
|
| Rate for Payer: BCBS MAPPO |
$649.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,134.32
|
| Rate for Payer: BCN Commercial |
$2,134.32
|
| Rate for Payer: BCN Medicare Advantage |
$649.04
|
| Rate for Payer: Cash Price |
$2,076.94
|
| Rate for Payer: Cofinity Commercial |
$2,232.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,076.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$649.04
|
| Rate for Payer: Healthscope Commercial |
$2,336.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.13
|
| Rate for Payer: Mclaren Medicaid |
$457.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$681.50
|
| Rate for Payer: Meridian Medicaid |
$480.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$746.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$713.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.75
|
| Rate for Payer: Nomi Health Commercial |
$2,128.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.13
|
| Rate for Payer: PACE Senior Care Partners |
$616.59
|
| Rate for Payer: PACE SWMI |
$649.04
|
| Rate for Payer: PHP Commercial |
$2,206.75
|
| Rate for Payer: PHP Medicare Advantage |
$649.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,258.68
|
| Rate for Payer: Priority Health Medicare |
$655.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,806.94
|
| Rate for Payer: Railroad Medicare Medicare |
$649.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,284.64
|
| Rate for Payer: UHC Core |
$2,167.81
|
| Rate for Payer: UHC Exchange |
$649.04
|
| Rate for Payer: UHC Medicaid |
$457.71
|
| Rate for Payer: UHC Medicare Advantage |
$649.04
|
| Rate for Payer: UHCCP Medicaid |
$457.71
|
| Rate for Payer: VA VA |
$649.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.13
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$105.30
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$18.56 |
| Max. Negotiated Rate |
$94.77 |
| Rate for Payer: Aetna Commercial |
$89.50
|
| Rate for Payer: Aetna Medicare |
$27.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.91
|
| Rate for Payer: BCBS Complete |
$19.49
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCBS Trust/PPO |
$86.57
|
| Rate for Payer: BCN Commercial |
$86.57
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$90.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$94.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.97
|
| Rate for Payer: Mclaren Medicaid |
$18.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Meridian Medicaid |
$19.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.50
|
| Rate for Payer: Nomi Health Commercial |
$86.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.97
|
| Rate for Payer: PACE Senior Care Partners |
$25.01
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PHP Commercial |
$89.50
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.61
|
| Rate for Payer: Priority Health Medicare |
$26.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.29
|
| Rate for Payer: Railroad Medicare Medicare |
$26.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.66
|
| Rate for Payer: UHC Core |
$87.93
|
| Rate for Payer: UHC Exchange |
$26.32
|
| Rate for Payer: UHC Medicaid |
$18.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UHCCP Medicaid |
$18.56
|
| Rate for Payer: VA VA |
$26.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.97
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
IP
|
$105.30
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$73.29 |
| Max. Negotiated Rate |
$94.77 |
| Rate for Payer: Aetna Commercial |
$89.50
|
| Rate for Payer: BCBS Trust/PPO |
$86.97
|
| Rate for Payer: BCN Commercial |
$86.97
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Cofinity Commercial |
$90.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.24
|
| Rate for Payer: Healthscope Commercial |
$94.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.50
|
| Rate for Payer: Nomi Health Commercial |
$86.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.97
|
| Rate for Payer: PHP Commercial |
$89.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.66
|
| Rate for Payer: UHC Core |
$87.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.97
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
OP
|
$289.51
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.04 |
| Max. Negotiated Rate |
$260.56 |
| Rate for Payer: Aetna Commercial |
$246.08
|
| Rate for Payer: Aetna Medicare |
$75.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.47
|
| Rate for Payer: BCBS Complete |
$53.59
|
| Rate for Payer: BCBS MAPPO |
$72.38
|
| Rate for Payer: BCBS Trust/PPO |
$238.01
|
| Rate for Payer: BCN Commercial |
$238.01
|
| Rate for Payer: BCN Medicare Advantage |
$72.38
|
| Rate for Payer: Cash Price |
$231.61
|
| Rate for Payer: Cofinity Commercial |
$248.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.38
|
| Rate for Payer: Healthscope Commercial |
$260.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.13
|
| Rate for Payer: Mclaren Medicaid |
$51.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.00
|
| Rate for Payer: Meridian Medicaid |
$53.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.08
|
| Rate for Payer: Nomi Health Commercial |
$237.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.13
|
| Rate for Payer: PACE Senior Care Partners |
$68.76
|
| Rate for Payer: PACE SWMI |
$72.38
|
| Rate for Payer: PHP Commercial |
$246.08
|
| Rate for Payer: PHP Medicare Advantage |
$72.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.87
|
| Rate for Payer: Priority Health Medicare |
$73.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.50
|
| Rate for Payer: Railroad Medicare Medicare |
$72.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.77
|
| Rate for Payer: UHC Core |
$241.74
|
| Rate for Payer: UHC Exchange |
$72.38
|
| Rate for Payer: UHC Medicaid |
$51.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.38
|
| Rate for Payer: UHCCP Medicaid |
$51.04
|
| Rate for Payer: VA VA |
$72.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.13
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
IP
|
$289.51
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.50 |
| Max. Negotiated Rate |
$260.56 |
| Rate for Payer: Aetna Commercial |
$246.08
|
| Rate for Payer: BCBS Trust/PPO |
$239.11
|
| Rate for Payer: BCN Commercial |
$239.11
|
| Rate for Payer: Cash Price |
$231.61
|
| Rate for Payer: Cofinity Commercial |
$248.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.61
|
| Rate for Payer: Healthscope Commercial |
$260.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.08
|
| Rate for Payer: Nomi Health Commercial |
$237.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.13
|
| Rate for Payer: PHP Commercial |
$246.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$251.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.77
|
| Rate for Payer: UHC Core |
$241.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.13
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
IP
|
$697.98
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.79 |
| Max. Negotiated Rate |
$628.18 |
| Rate for Payer: Aetna Commercial |
$593.28
|
| Rate for Payer: BCBS Trust/PPO |
$576.46
|
| Rate for Payer: BCN Commercial |
$576.46
|
| Rate for Payer: Cash Price |
$558.38
|
| Rate for Payer: Cofinity Commercial |
$600.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.38
|
| Rate for Payer: Healthscope Commercial |
$628.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$523.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.28
|
| Rate for Payer: Nomi Health Commercial |
$572.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.49
|
| Rate for Payer: PHP Commercial |
$593.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$607.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$614.22
|
| Rate for Payer: UHC Core |
$582.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$523.49
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
OP
|
$697.98
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.05 |
| Max. Negotiated Rate |
$628.18 |
| Rate for Payer: Aetna Commercial |
$593.28
|
| Rate for Payer: Aetna Medicare |
$181.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.12
|
| Rate for Payer: BCBS Complete |
$129.20
|
| Rate for Payer: BCBS MAPPO |
$174.50
|
| Rate for Payer: BCBS Trust/PPO |
$573.81
|
| Rate for Payer: BCN Commercial |
$573.81
|
| Rate for Payer: BCN Medicare Advantage |
$174.50
|
| Rate for Payer: Cash Price |
$558.38
|
| Rate for Payer: Cofinity Commercial |
$600.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$558.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.50
|
| Rate for Payer: Healthscope Commercial |
$628.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$523.49
|
| Rate for Payer: Mclaren Medicaid |
$123.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.22
|
| Rate for Payer: Meridian Medicaid |
$129.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$593.28
|
| Rate for Payer: Nomi Health Commercial |
$572.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$523.49
|
| Rate for Payer: PACE Senior Care Partners |
$165.77
|
| Rate for Payer: PACE SWMI |
$174.50
|
| Rate for Payer: PHP Commercial |
$593.28
|
| Rate for Payer: PHP Medicare Advantage |
$174.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$607.24
|
| Rate for Payer: Priority Health Medicare |
$176.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.79
|
| Rate for Payer: Railroad Medicare Medicare |
$174.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$614.22
|
| Rate for Payer: UHC Core |
$582.81
|
| Rate for Payer: UHC Exchange |
$174.50
|
| Rate for Payer: UHC Medicaid |
$123.05
|
| Rate for Payer: UHC Medicare Advantage |
$174.50
|
| Rate for Payer: UHCCP Medicaid |
$123.05
|
| Rate for Payer: VA VA |
$174.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$523.49
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
OP
|
$976.17
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$172.10 |
| Max. Negotiated Rate |
$878.55 |
| Rate for Payer: Aetna Commercial |
$829.74
|
| Rate for Payer: Aetna Medicare |
$253.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.05
|
| Rate for Payer: BCBS Complete |
$180.69
|
| Rate for Payer: BCBS MAPPO |
$244.04
|
| Rate for Payer: BCBS Trust/PPO |
$802.51
|
| Rate for Payer: BCN Commercial |
$802.51
|
| Rate for Payer: BCN Medicare Advantage |
$244.04
|
| Rate for Payer: Cash Price |
$780.94
|
| Rate for Payer: Cofinity Commercial |
$839.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.04
|
| Rate for Payer: Healthscope Commercial |
$878.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.13
|
| Rate for Payer: Mclaren Medicaid |
$172.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.24
|
| Rate for Payer: Meridian Medicaid |
$180.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$268.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.74
|
| Rate for Payer: Nomi Health Commercial |
$800.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.13
|
| Rate for Payer: PACE Senior Care Partners |
$231.84
|
| Rate for Payer: PACE SWMI |
$244.04
|
| Rate for Payer: PHP Commercial |
$829.74
|
| Rate for Payer: PHP Medicare Advantage |
$244.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$849.27
|
| Rate for Payer: Priority Health Medicare |
$246.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$679.41
|
| Rate for Payer: Railroad Medicare Medicare |
$244.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.03
|
| Rate for Payer: UHC Core |
$815.10
|
| Rate for Payer: UHC Exchange |
$244.04
|
| Rate for Payer: UHC Medicaid |
$172.10
|
| Rate for Payer: UHC Medicare Advantage |
$244.04
|
| Rate for Payer: UHCCP Medicaid |
$172.10
|
| Rate for Payer: VA VA |
$244.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.13
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
IP
|
$976.17
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$679.41 |
| Max. Negotiated Rate |
$878.55 |
| Rate for Payer: Aetna Commercial |
$829.74
|
| Rate for Payer: BCBS Trust/PPO |
$806.22
|
| Rate for Payer: BCN Commercial |
$806.22
|
| Rate for Payer: Cash Price |
$780.94
|
| Rate for Payer: Cofinity Commercial |
$839.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.94
|
| Rate for Payer: Healthscope Commercial |
$878.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.74
|
| Rate for Payer: Nomi Health Commercial |
$800.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$732.13
|
| Rate for Payer: PHP Commercial |
$829.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$849.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$679.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.03
|
| Rate for Payer: UHC Core |
$815.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.13
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
IP
|
$721.55
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$502.20 |
| Max. Negotiated Rate |
$649.39 |
| Rate for Payer: Aetna Commercial |
$613.32
|
| Rate for Payer: BCBS Trust/PPO |
$595.93
|
| Rate for Payer: BCN Commercial |
$595.93
|
| Rate for Payer: Cash Price |
$577.24
|
| Rate for Payer: Cofinity Commercial |
$620.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.24
|
| Rate for Payer: Healthscope Commercial |
$649.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.32
|
| Rate for Payer: Nomi Health Commercial |
$591.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$541.16
|
| Rate for Payer: PHP Commercial |
$613.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$627.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.96
|
| Rate for Payer: UHC Core |
$602.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.16
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
OP
|
$721.55
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.21 |
| Max. Negotiated Rate |
$649.39 |
| Rate for Payer: Aetna Commercial |
$613.32
|
| Rate for Payer: Aetna Medicare |
$187.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.48
|
| Rate for Payer: BCBS Complete |
$133.56
|
| Rate for Payer: BCBS MAPPO |
$180.39
|
| Rate for Payer: BCBS Trust/PPO |
$593.19
|
| Rate for Payer: BCN Commercial |
$593.19
|
| Rate for Payer: BCN Medicare Advantage |
$180.39
|
| Rate for Payer: Cash Price |
$577.24
|
| Rate for Payer: Cofinity Commercial |
$620.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.39
|
| Rate for Payer: Healthscope Commercial |
$649.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.16
|
| Rate for Payer: Mclaren Medicaid |
$127.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.41
|
| Rate for Payer: Meridian Medicaid |
$133.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$198.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.32
|
| Rate for Payer: Nomi Health Commercial |
$591.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$541.16
|
| Rate for Payer: PACE Senior Care Partners |
$171.37
|
| Rate for Payer: PACE SWMI |
$180.39
|
| Rate for Payer: PHP Commercial |
$613.32
|
| Rate for Payer: PHP Medicare Advantage |
$180.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$627.75
|
| Rate for Payer: Priority Health Medicare |
$182.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$502.20
|
| Rate for Payer: Railroad Medicare Medicare |
$180.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.96
|
| Rate for Payer: UHC Core |
$602.49
|
| Rate for Payer: UHC Exchange |
$180.39
|
| Rate for Payer: UHC Medicaid |
$127.21
|
| Rate for Payer: UHC Medicare Advantage |
$180.39
|
| Rate for Payer: UHCCP Medicaid |
$127.21
|
| Rate for Payer: VA VA |
$180.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.16
|
|
|
HC PERITONEOGRAM
|
Facility
|
IP
|
$580.04
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$403.71 |
| Max. Negotiated Rate |
$522.04 |
| Rate for Payer: Aetna Commercial |
$493.03
|
| Rate for Payer: BCBS Trust/PPO |
$479.06
|
| Rate for Payer: BCN Commercial |
$479.06
|
| Rate for Payer: Cash Price |
$464.03
|
| Rate for Payer: Cofinity Commercial |
$498.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.03
|
| Rate for Payer: Healthscope Commercial |
$522.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.03
|
| Rate for Payer: Nomi Health Commercial |
$475.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.03
|
| Rate for Payer: PHP Commercial |
$493.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$504.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.44
|
| Rate for Payer: UHC Core |
$484.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.03
|
|
|
HC PERITONEOGRAM
|
Facility
|
OP
|
$580.04
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$102.26 |
| Max. Negotiated Rate |
$522.04 |
| Rate for Payer: Aetna Commercial |
$493.03
|
| Rate for Payer: Aetna Medicare |
$150.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.26
|
| Rate for Payer: BCBS Complete |
$107.37
|
| Rate for Payer: BCBS MAPPO |
$145.01
|
| Rate for Payer: BCBS Trust/PPO |
$476.85
|
| Rate for Payer: BCN Commercial |
$476.85
|
| Rate for Payer: BCN Medicare Advantage |
$145.01
|
| Rate for Payer: Cash Price |
$464.03
|
| Rate for Payer: Cofinity Commercial |
$498.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.01
|
| Rate for Payer: Healthscope Commercial |
$522.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.03
|
| Rate for Payer: Mclaren Medicaid |
$102.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.26
|
| Rate for Payer: Meridian Medicaid |
$107.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.03
|
| Rate for Payer: Nomi Health Commercial |
$475.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.03
|
| Rate for Payer: PACE Senior Care Partners |
$137.76
|
| Rate for Payer: PACE SWMI |
$145.01
|
| Rate for Payer: PHP Commercial |
$493.03
|
| Rate for Payer: PHP Medicare Advantage |
$145.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$504.63
|
| Rate for Payer: Priority Health Medicare |
$146.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.71
|
| Rate for Payer: Railroad Medicare Medicare |
$145.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.44
|
| Rate for Payer: UHC Core |
$484.33
|
| Rate for Payer: UHC Exchange |
$145.01
|
| Rate for Payer: UHC Medicaid |
$102.26
|
| Rate for Payer: UHC Medicare Advantage |
$145.01
|
| Rate for Payer: UHCCP Medicaid |
$102.26
|
| Rate for Payer: VA VA |
$145.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.03
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
OP
|
$252.01
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.43 |
| Max. Negotiated Rate |
$226.81 |
| Rate for Payer: Aetna Commercial |
$214.21
|
| Rate for Payer: Aetna Medicare |
$65.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.75
|
| Rate for Payer: BCBS Complete |
$46.65
|
| Rate for Payer: BCBS MAPPO |
$63.00
|
| Rate for Payer: BCBS Trust/PPO |
$207.18
|
| Rate for Payer: BCN Commercial |
$207.18
|
| Rate for Payer: BCN Medicare Advantage |
$63.00
|
| Rate for Payer: Cash Price |
$201.61
|
| Rate for Payer: Cofinity Commercial |
$216.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.00
|
| Rate for Payer: Healthscope Commercial |
$226.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.01
|
| Rate for Payer: Mclaren Medicaid |
$44.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.15
|
| Rate for Payer: Meridian Medicaid |
$46.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.21
|
| Rate for Payer: Nomi Health Commercial |
$206.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.01
|
| Rate for Payer: PACE Senior Care Partners |
$59.85
|
| Rate for Payer: PACE SWMI |
$63.00
|
| Rate for Payer: PHP Commercial |
$214.21
|
| Rate for Payer: PHP Medicare Advantage |
$63.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.25
|
| Rate for Payer: Priority Health Medicare |
$63.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.40
|
| Rate for Payer: Railroad Medicare Medicare |
$63.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.77
|
| Rate for Payer: UHC Core |
$210.43
|
| Rate for Payer: UHC Exchange |
$63.00
|
| Rate for Payer: UHC Medicaid |
$44.43
|
| Rate for Payer: UHC Medicare Advantage |
$63.00
|
| Rate for Payer: UHCCP Medicaid |
$44.43
|
| Rate for Payer: VA VA |
$63.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.01
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
IP
|
$252.01
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$226.81 |
| Rate for Payer: Aetna Commercial |
$214.21
|
| Rate for Payer: BCBS Trust/PPO |
$208.14
|
| Rate for Payer: BCN Commercial |
$208.14
|
| Rate for Payer: Cash Price |
$201.61
|
| Rate for Payer: Cofinity Commercial |
$216.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.61
|
| Rate for Payer: Healthscope Commercial |
$226.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.21
|
| Rate for Payer: Nomi Health Commercial |
$206.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.01
|
| Rate for Payer: PHP Commercial |
$214.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.77
|
| Rate for Payer: UHC Core |
$210.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.01
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
IP
|
$343.45
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$239.04 |
| Max. Negotiated Rate |
$309.11 |
| Rate for Payer: Aetna Commercial |
$291.93
|
| Rate for Payer: BCBS Trust/PPO |
$283.66
|
| Rate for Payer: BCN Commercial |
$283.66
|
| Rate for Payer: Cash Price |
$274.76
|
| Rate for Payer: Cofinity Commercial |
$295.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.76
|
| Rate for Payer: Healthscope Commercial |
$309.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.93
|
| Rate for Payer: Nomi Health Commercial |
$281.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.59
|
| Rate for Payer: PHP Commercial |
$291.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.24
|
| Rate for Payer: UHC Core |
$286.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.59
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
OP
|
$343.45
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.55 |
| Max. Negotiated Rate |
$309.11 |
| Rate for Payer: Aetna Commercial |
$291.93
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.33
|
| Rate for Payer: BCBS Complete |
$63.57
|
| Rate for Payer: BCBS MAPPO |
$85.86
|
| Rate for Payer: BCBS Trust/PPO |
$282.35
|
| Rate for Payer: BCN Commercial |
$282.35
|
| Rate for Payer: BCN Medicare Advantage |
$85.86
|
| Rate for Payer: Cash Price |
$274.76
|
| Rate for Payer: Cofinity Commercial |
$295.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.86
|
| Rate for Payer: Healthscope Commercial |
$309.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.59
|
| Rate for Payer: Mclaren Medicaid |
$60.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$63.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.93
|
| Rate for Payer: Nomi Health Commercial |
$281.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.59
|
| Rate for Payer: PACE Senior Care Partners |
$81.57
|
| Rate for Payer: PACE SWMI |
$85.86
|
| Rate for Payer: PHP Commercial |
$291.93
|
| Rate for Payer: PHP Medicare Advantage |
$85.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.80
|
| Rate for Payer: Priority Health Medicare |
$86.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.04
|
| Rate for Payer: Railroad Medicare Medicare |
$85.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.24
|
| Rate for Payer: UHC Core |
$286.78
|
| Rate for Payer: UHC Exchange |
$85.86
|
| Rate for Payer: UHC Medicaid |
$60.55
|
| Rate for Payer: UHC Medicare Advantage |
$85.86
|
| Rate for Payer: UHCCP Medicaid |
$60.55
|
| Rate for Payer: VA VA |
$85.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.59
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
OP
|
$1,804.05
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.05 |
| Max. Negotiated Rate |
$1,623.64 |
| Rate for Payer: Aetna Commercial |
$1,533.44
|
| Rate for Payer: Aetna Medicare |
$469.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$563.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$563.77
|
| Rate for Payer: BCBS Complete |
$333.93
|
| Rate for Payer: BCBS MAPPO |
$451.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,483.11
|
| Rate for Payer: BCN Commercial |
$1,483.11
|
| Rate for Payer: BCN Medicare Advantage |
$451.01
|
| Rate for Payer: Cash Price |
$1,443.24
|
| Rate for Payer: Cofinity Commercial |
$1,551.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,443.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.01
|
| Rate for Payer: Healthscope Commercial |
$1,623.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,353.04
|
| Rate for Payer: Mclaren Medicaid |
$318.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.56
|
| Rate for Payer: Meridian Medicaid |
$333.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$518.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$496.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,533.44
|
| Rate for Payer: Nomi Health Commercial |
$1,479.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.04
|
| Rate for Payer: PACE Senior Care Partners |
$428.46
|
| Rate for Payer: PACE SWMI |
$451.01
|
| Rate for Payer: PHP Commercial |
$1,533.44
|
| Rate for Payer: PHP Medicare Advantage |
$451.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,569.52
|
| Rate for Payer: Priority Health Medicare |
$455.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.62
|
| Rate for Payer: Railroad Medicare Medicare |
$451.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,587.56
|
| Rate for Payer: UHC Core |
$1,506.38
|
| Rate for Payer: UHC Exchange |
$451.01
|
| Rate for Payer: UHC Medicaid |
$318.05
|
| Rate for Payer: UHC Medicare Advantage |
$451.01
|
| Rate for Payer: UHCCP Medicaid |
$318.05
|
| Rate for Payer: VA VA |
$451.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,353.04
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
IP
|
$1,804.05
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,255.62 |
| Max. Negotiated Rate |
$1,623.64 |
| Rate for Payer: Aetna Commercial |
$1,533.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,489.96
|
| Rate for Payer: BCN Commercial |
$1,489.96
|
| Rate for Payer: Cash Price |
$1,443.24
|
| Rate for Payer: Cofinity Commercial |
$1,551.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,443.24
|
| Rate for Payer: Healthscope Commercial |
$1,623.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,353.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,533.44
|
| Rate for Payer: Nomi Health Commercial |
$1,479.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,353.04
|
| Rate for Payer: PHP Commercial |
$1,533.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,569.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,255.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,587.56
|
| Rate for Payer: UHC Core |
$1,506.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,353.04
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
IP
|
$451.89
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.52 |
| Max. Negotiated Rate |
$406.70 |
| Rate for Payer: Aetna Commercial |
$384.11
|
| Rate for Payer: BCBS Trust/PPO |
$373.22
|
| Rate for Payer: BCN Commercial |
$373.22
|
| Rate for Payer: Cash Price |
$361.51
|
| Rate for Payer: Cofinity Commercial |
$388.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.51
|
| Rate for Payer: Healthscope Commercial |
$406.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.11
|
| Rate for Payer: Nomi Health Commercial |
$370.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$338.92
|
| Rate for Payer: PHP Commercial |
$384.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$393.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.66
|
| Rate for Payer: UHC Core |
$377.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.92
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
OP
|
$451.89
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.67 |
| Max. Negotiated Rate |
$406.70 |
| Rate for Payer: Aetna Commercial |
$384.11
|
| Rate for Payer: Aetna Medicare |
$117.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.22
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$112.97
|
| Rate for Payer: BCBS Trust/PPO |
$371.50
|
| Rate for Payer: BCN Commercial |
$371.50
|
| Rate for Payer: BCN Medicare Advantage |
$112.97
|
| Rate for Payer: Cash Price |
$361.51
|
| Rate for Payer: Cofinity Commercial |
$388.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.97
|
| Rate for Payer: Healthscope Commercial |
$406.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.92
|
| Rate for Payer: Mclaren Medicaid |
$79.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.62
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$124.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.11
|
| Rate for Payer: Nomi Health Commercial |
$370.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$338.92
|
| Rate for Payer: PACE Senior Care Partners |
$107.32
|
| Rate for Payer: PACE SWMI |
$112.97
|
| Rate for Payer: PHP Commercial |
$384.11
|
| Rate for Payer: PHP Medicare Advantage |
$112.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$393.14
|
| Rate for Payer: Priority Health Medicare |
$114.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.52
|
| Rate for Payer: Railroad Medicare Medicare |
$112.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.66
|
| Rate for Payer: UHC Core |
$377.33
|
| Rate for Payer: UHC Exchange |
$112.97
|
| Rate for Payer: UHC Medicaid |
$79.67
|
| Rate for Payer: UHC Medicare Advantage |
$112.97
|
| Rate for Payer: UHCCP Medicaid |
$79.67
|
| Rate for Payer: VA VA |
$112.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.92
|
|
