|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$518.79 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: BCBS Trust/PPO |
$657.36
|
| Rate for Payer: BCN Commercial |
$657.36
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.55
|
| Rate for Payer: UHC Core |
$710.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: Aetna Medicare |
$221.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.82
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$212.66
|
| Rate for Payer: BCBS Trust/PPO |
$661.36
|
| Rate for Payer: BCN Commercial |
$661.36
|
| Rate for Payer: BCN Medicare Advantage |
$212.66
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.66
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PACE Senior Care Partners |
$202.02
|
| Rate for Payer: PACE SWMI |
$212.66
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: PHP Medicare Advantage |
$212.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.04
|
| Rate for Payer: Priority Health Medicare |
$212.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.79
|
| Rate for Payer: Railroad Medicare Medicare |
$212.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.55
|
| Rate for Payer: UHC Core |
$710.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.66
|
| Rate for Payer: UHC Medicare Advantage |
$219.03
|
| Rate for Payer: VA VA |
$212.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,365.65
|
|
|
Service Code
|
HCPCS c1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$561.84 |
| Max. Negotiated Rate |
$2,129.08 |
| Rate for Payer: Aetna Commercial |
$2,010.80
|
| Rate for Payer: Aetna Medicare |
$615.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$739.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$739.27
|
| Rate for Payer: BCBS Complete |
$946.26
|
| Rate for Payer: BCBS MAPPO |
$591.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,839.29
|
| Rate for Payer: BCN Commercial |
$1,839.29
|
| Rate for Payer: BCN Medicare Advantage |
$591.41
|
| Rate for Payer: Cash Price |
$1,892.52
|
| Rate for Payer: Cofinity Commercial |
$2,034.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.41
|
| Rate for Payer: Healthscope Commercial |
$2,129.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$620.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$680.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,010.80
|
| Rate for Payer: PACE Senior Care Partners |
$561.84
|
| Rate for Payer: PACE SWMI |
$591.41
|
| Rate for Payer: PHP Commercial |
$2,010.80
|
| Rate for Payer: PHP Medicare Advantage |
$591.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,058.12
|
| Rate for Payer: Priority Health Medicare |
$591.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.81
|
| Rate for Payer: Railroad Medicare Medicare |
$591.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,081.77
|
| Rate for Payer: UHC Core |
$1,975.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.41
|
| Rate for Payer: UHC Medicare Advantage |
$609.15
|
| Rate for Payer: VA VA |
$591.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.24
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,365.65
|
|
|
Service Code
|
HCPCS c1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,442.81 |
| Max. Negotiated Rate |
$2,129.08 |
| Rate for Payer: Aetna Commercial |
$2,010.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,828.17
|
| Rate for Payer: BCN Commercial |
$1,828.17
|
| Rate for Payer: Cash Price |
$1,892.52
|
| Rate for Payer: Cofinity Commercial |
$2,034.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.52
|
| Rate for Payer: Healthscope Commercial |
$2,129.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,010.80
|
| Rate for Payer: PHP Commercial |
$2,010.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,655.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,058.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,081.77
|
| Rate for Payer: UHC Core |
$1,975.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.24
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,890.65
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,763.01 |
| Max. Negotiated Rate |
$2,601.58 |
| Rate for Payer: Aetna Commercial |
$2,457.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,233.89
|
| Rate for Payer: BCN Commercial |
$2,233.89
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cofinity Commercial |
$2,485.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,312.52
|
| Rate for Payer: Healthscope Commercial |
$2,601.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,457.05
|
| Rate for Payer: PHP Commercial |
$2,457.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,023.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,514.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,763.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,543.77
|
| Rate for Payer: UHC Core |
$2,413.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.99
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,890.65
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$686.53 |
| Max. Negotiated Rate |
$2,601.58 |
| Rate for Payer: Aetna Commercial |
$2,457.05
|
| Rate for Payer: Aetna Medicare |
$751.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$903.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$903.33
|
| Rate for Payer: BCBS Complete |
$1,156.26
|
| Rate for Payer: BCBS MAPPO |
$722.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,247.48
|
| Rate for Payer: BCN Commercial |
$2,247.48
|
| Rate for Payer: BCN Medicare Advantage |
$722.66
|
| Rate for Payer: Cash Price |
$2,312.52
|
| Rate for Payer: Cofinity Commercial |
$2,485.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,312.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.66
|
| Rate for Payer: Healthscope Commercial |
$2,601.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$758.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$831.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,457.05
|
| Rate for Payer: PACE Senior Care Partners |
$686.53
|
| Rate for Payer: PACE SWMI |
$722.66
|
| Rate for Payer: PHP Commercial |
$2,457.05
|
| Rate for Payer: PHP Medicare Advantage |
$722.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,023.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,514.87
|
| Rate for Payer: Priority Health Medicare |
$722.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,763.01
|
| Rate for Payer: Railroad Medicare Medicare |
$722.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,543.77
|
| Rate for Payer: UHC Core |
$2,413.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$722.66
|
| Rate for Payer: UHC Medicare Advantage |
$744.34
|
| Rate for Payer: VA VA |
$722.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.99
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$400.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.02 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$104.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.02
|
| Rate for Payer: BCBS Complete |
$160.03
|
| Rate for Payer: BCBS MAPPO |
$100.02
|
| Rate for Payer: BCBS Trust/PPO |
$311.05
|
| Rate for Payer: BCN Commercial |
$311.05
|
| Rate for Payer: BCN Medicare Advantage |
$100.02
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.02
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.06
|
| Rate for Payer: PACE Senior Care Partners |
$95.02
|
| Rate for Payer: PACE SWMI |
$100.02
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: PHP Medicare Advantage |
$100.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.06
|
| Rate for Payer: Priority Health Medicare |
$100.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.00
|
| Rate for Payer: Railroad Medicare Medicare |
$100.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.02
|
| Rate for Payer: UHC Medicare Advantage |
$103.02
|
| Rate for Payer: VA VA |
$100.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$400.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$244.00 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: BCBS Trust/PPO |
$309.17
|
| Rate for Payer: BCN Commercial |
$309.17
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.06
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$34.78
|
| Rate for Payer: BCN Commercial |
$34.78
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.60
|
| Rate for Payer: UHC Core |
$37.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.75
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna Medicare |
$11.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.06
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$11.25
|
| Rate for Payer: BCBS Trust/PPO |
$34.99
|
| Rate for Payer: BCN Commercial |
$34.99
|
| Rate for Payer: BCN Medicare Advantage |
$11.25
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.25
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PACE Senior Care Partners |
$10.69
|
| Rate for Payer: PACE SWMI |
$11.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: PHP Medicare Advantage |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.15
|
| Rate for Payer: Priority Health Medicare |
$11.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.60
|
| Rate for Payer: UHC Core |
$37.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.59
|
| Rate for Payer: VA VA |
$11.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.75
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,645.04
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,053.20 |
| Max. Negotiated Rate |
$7,780.54 |
| Rate for Payer: Aetna Commercial |
$7,348.28
|
| Rate for Payer: Aetna Medicare |
$2,247.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,701.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,701.58
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$2,161.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,721.52
|
| Rate for Payer: BCN Commercial |
$6,721.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,161.26
|
| Rate for Payer: Cash Price |
$6,916.03
|
| Rate for Payer: Cash Price |
$6,916.03
|
| Rate for Payer: Cofinity Commercial |
$7,434.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,916.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,161.26
|
| Rate for Payer: Healthscope Commercial |
$7,780.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,483.78
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,269.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,485.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,348.28
|
| Rate for Payer: PACE Senior Care Partners |
$2,053.20
|
| Rate for Payer: PACE SWMI |
$2,161.26
|
| Rate for Payer: PHP Commercial |
$7,348.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,161.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,051.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,521.18
|
| Rate for Payer: Priority Health Medicare |
$2,161.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,272.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,161.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,607.64
|
| Rate for Payer: UHC Core |
$7,218.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,161.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,226.10
|
| Rate for Payer: VA VA |
$2,161.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,483.78
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,645.04
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,272.61 |
| Max. Negotiated Rate |
$7,780.54 |
| Rate for Payer: Aetna Commercial |
$7,348.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,680.89
|
| Rate for Payer: BCN Commercial |
$6,680.89
|
| Rate for Payer: Cash Price |
$6,916.03
|
| Rate for Payer: Cofinity Commercial |
$7,434.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,916.03
|
| Rate for Payer: Healthscope Commercial |
$7,780.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,483.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,348.28
|
| Rate for Payer: PHP Commercial |
$7,348.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,051.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,521.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,272.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,607.64
|
| Rate for Payer: UHC Core |
$7,218.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,483.78
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$4,919.81
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,000.59 |
| Max. Negotiated Rate |
$4,427.83 |
| Rate for Payer: Aetna Commercial |
$4,181.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,802.03
|
| Rate for Payer: BCN Commercial |
$3,802.03
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cofinity Commercial |
$4,231.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,935.85
|
| Rate for Payer: Healthscope Commercial |
$4,427.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,689.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,181.84
|
| Rate for Payer: PHP Commercial |
$4,181.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,443.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,280.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,000.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,329.43
|
| Rate for Payer: UHC Core |
$4,108.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,689.86
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$4,919.81
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,168.45 |
| Max. Negotiated Rate |
$4,427.83 |
| Rate for Payer: Aetna Commercial |
$4,181.84
|
| Rate for Payer: Aetna Medicare |
$1,279.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,537.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,537.44
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,229.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,825.15
|
| Rate for Payer: BCN Commercial |
$3,825.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,229.95
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cofinity Commercial |
$4,231.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,935.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,229.95
|
| Rate for Payer: Healthscope Commercial |
$4,427.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,689.86
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,291.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,414.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,181.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,168.45
|
| Rate for Payer: PACE SWMI |
$1,229.95
|
| Rate for Payer: PHP Commercial |
$4,181.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,229.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,443.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,280.23
|
| Rate for Payer: Priority Health Medicare |
$1,229.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,000.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,229.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,329.43
|
| Rate for Payer: UHC Core |
$4,108.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,229.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,266.85
|
| Rate for Payer: VA VA |
$1,229.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,689.86
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,394.47
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,460.39 |
| Max. Negotiated Rate |
$2,155.02 |
| Rate for Payer: Aetna Commercial |
$2,035.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,850.45
|
| Rate for Payer: BCN Commercial |
$1,850.45
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cofinity Commercial |
$2,059.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,915.58
|
| Rate for Payer: Healthscope Commercial |
$2,155.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,795.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,035.30
|
| Rate for Payer: PHP Commercial |
$2,035.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,083.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,460.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,107.13
|
| Rate for Payer: UHC Core |
$1,999.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,795.85
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,394.47
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$568.69 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$2,035.30
|
| Rate for Payer: Aetna Medicare |
$622.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$748.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$748.27
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$598.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,861.70
|
| Rate for Payer: BCN Commercial |
$1,861.70
|
| Rate for Payer: BCN Medicare Advantage |
$598.62
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cofinity Commercial |
$2,059.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,915.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.62
|
| Rate for Payer: Healthscope Commercial |
$2,155.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,795.85
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$628.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$688.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,035.30
|
| Rate for Payer: PACE Senior Care Partners |
$568.69
|
| Rate for Payer: PACE SWMI |
$598.62
|
| Rate for Payer: PHP Commercial |
$2,035.30
|
| Rate for Payer: PHP Medicare Advantage |
$598.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,083.19
|
| Rate for Payer: Priority Health Medicare |
$598.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,460.39
|
| Rate for Payer: Railroad Medicare Medicare |
$598.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,107.13
|
| Rate for Payer: UHC Core |
$1,999.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.62
|
| Rate for Payer: UHC Medicare Advantage |
$616.58
|
| Rate for Payer: VA VA |
$598.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,795.85
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,760.88
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,584.79 |
| Rate for Payer: Aetna Commercial |
$1,496.75
|
| Rate for Payer: Aetna Medicare |
$457.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$550.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$550.28
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$440.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.08
|
| Rate for Payer: BCN Commercial |
$1,369.08
|
| Rate for Payer: BCN Medicare Advantage |
$440.22
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cofinity Commercial |
$1,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.22
|
| Rate for Payer: Healthscope Commercial |
$1,584.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.66
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,496.75
|
| Rate for Payer: PACE Senior Care Partners |
$418.21
|
| Rate for Payer: PACE SWMI |
$440.22
|
| Rate for Payer: PHP Commercial |
$1,496.75
|
| Rate for Payer: PHP Medicare Advantage |
$440.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,531.97
|
| Rate for Payer: Priority Health Medicare |
$440.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,073.96
|
| Rate for Payer: Railroad Medicare Medicare |
$440.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.57
|
| Rate for Payer: UHC Core |
$1,470.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.22
|
| Rate for Payer: UHC Medicare Advantage |
$453.43
|
| Rate for Payer: VA VA |
$440.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.66
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,760.88
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,073.96 |
| Max. Negotiated Rate |
$1,584.79 |
| Rate for Payer: Aetna Commercial |
$1,496.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.81
|
| Rate for Payer: BCN Commercial |
$1,360.81
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cofinity Commercial |
$1,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.70
|
| Rate for Payer: Healthscope Commercial |
$1,584.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,496.75
|
| Rate for Payer: PHP Commercial |
$1,496.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,531.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,073.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.57
|
| Rate for Payer: UHC Core |
$1,470.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.66
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,553.46
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,777.16 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,518.91
|
| Rate for Payer: BCN Commercial |
$3,518.91
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,961.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,777.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,007.04
|
| Rate for Payer: UHC Core |
$3,802.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,553.46
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,081.45 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna Medicare |
$1,183.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,422.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,422.96
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,138.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,540.32
|
| Rate for Payer: BCN Commercial |
$3,540.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.36
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.36
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,195.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,309.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,081.45
|
| Rate for Payer: PACE SWMI |
$1,138.36
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,961.51
|
| Rate for Payer: Priority Health Medicare |
$1,138.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,777.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,007.04
|
| Rate for Payer: UHC Core |
$3,802.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.52
|
| Rate for Payer: VA VA |
$1,138.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna Medicare |
$359.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.58
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$345.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.78
|
| Rate for Payer: BCN Commercial |
$1,073.78
|
| Rate for Payer: BCN Medicare Advantage |
$345.27
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.27
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$362.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PACE Senior Care Partners |
$328.00
|
| Rate for Payer: PACE SWMI |
$345.27
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: PHP Medicare Advantage |
$345.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.53
|
| Rate for Payer: Priority Health Medicare |
$345.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.31
|
| Rate for Payer: Railroad Medicare Medicare |
$345.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.34
|
| Rate for Payer: UHC Core |
$1,153.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.27
|
| Rate for Payer: UHC Medicare Advantage |
$355.63
|
| Rate for Payer: VA VA |
$345.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$842.31 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.29
|
| Rate for Payer: BCN Commercial |
$1,067.29
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.34
|
| Rate for Payer: UHC Core |
$1,153.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$842.31 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.29
|
| Rate for Payer: BCN Commercial |
$1,067.29
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.34
|
| Rate for Payer: UHC Core |
$1,153.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna Medicare |
$359.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.58
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$345.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.78
|
| Rate for Payer: BCN Commercial |
$1,073.78
|
| Rate for Payer: BCN Medicare Advantage |
$345.27
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.27
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$362.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PACE Senior Care Partners |
$328.00
|
| Rate for Payer: PACE SWMI |
$345.27
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: PHP Medicare Advantage |
$345.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.53
|
| Rate for Payer: Priority Health Medicare |
$345.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.31
|
| Rate for Payer: Railroad Medicare Medicare |
$345.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,215.34
|
| Rate for Payer: UHC Core |
$1,153.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.27
|
| Rate for Payer: UHC Medicare Advantage |
$355.63
|
| Rate for Payer: VA VA |
$345.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: Aetna Medicare |
$221.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.82
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$212.66
|
| Rate for Payer: BCBS Trust/PPO |
$661.36
|
| Rate for Payer: BCN Commercial |
$661.36
|
| Rate for Payer: BCN Medicare Advantage |
$212.66
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.66
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PACE Senior Care Partners |
$202.02
|
| Rate for Payer: PACE SWMI |
$212.66
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: PHP Medicare Advantage |
$212.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.04
|
| Rate for Payer: Priority Health Medicare |
$212.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.79
|
| Rate for Payer: Railroad Medicare Medicare |
$212.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.55
|
| Rate for Payer: UHC Core |
$710.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.66
|
| Rate for Payer: UHC Medicare Advantage |
$219.03
|
| Rate for Payer: VA VA |
$212.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
