|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
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 VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,000.73
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$900.66 |
| Rate for Payer: Aetna Commercial |
$850.62
|
| Rate for Payer: Aetna Medicare |
$260.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$312.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$312.73
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$250.18
|
| Rate for Payer: BCBS Trust/PPO |
$778.07
|
| Rate for Payer: BCN Commercial |
$778.07
|
| Rate for Payer: BCN Medicare Advantage |
$250.18
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cofinity Commercial |
$860.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.18
|
| Rate for Payer: Healthscope Commercial |
$900.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.55
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.62
|
| Rate for Payer: PACE Senior Care Partners |
$237.67
|
| Rate for Payer: PACE SWMI |
$250.18
|
| Rate for Payer: PHP Commercial |
$850.62
|
| Rate for Payer: PHP Medicare Advantage |
$250.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.64
|
| Rate for Payer: Priority Health Medicare |
$250.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.35
|
| Rate for Payer: Railroad Medicare Medicare |
$250.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.64
|
| Rate for Payer: UHC Core |
$835.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.18
|
| Rate for Payer: UHC Medicare Advantage |
$257.69
|
| Rate for Payer: VA VA |
$250.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.55
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,000.73
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$610.35 |
| Max. Negotiated Rate |
$900.66 |
| Rate for Payer: Aetna Commercial |
$850.62
|
| Rate for Payer: BCBS Trust/PPO |
$773.36
|
| Rate for Payer: BCN Commercial |
$773.36
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cofinity Commercial |
$860.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.58
|
| Rate for Payer: Healthscope Commercial |
$900.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.62
|
| Rate for Payer: PHP Commercial |
$850.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.64
|
| Rate for Payer: UHC Core |
$835.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.55
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$30.00
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.18
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$30.00
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.32
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.72
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,856.63 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: BCBS Trust/PPO |
$6,153.81
|
| Rate for Payer: BCN Commercial |
$6,153.81
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,891.21 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna Medicare |
$2,070.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,488.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,488.44
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,990.75
|
| Rate for Payer: BCBS Trust/PPO |
$6,191.23
|
| Rate for Payer: BCN Commercial |
$6,191.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,990.75
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,990.75
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,090.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,289.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,891.21
|
| Rate for Payer: PACE SWMI |
$1,990.75
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,990.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Medicare |
$1,990.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,990.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,990.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,050.47
|
| Rate for Payer: VA VA |
$1,990.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$841.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$513.24 |
| Max. Negotiated Rate |
$757.36 |
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: BCBS Trust/PPO |
$650.32
|
| Rate for Payer: BCN Commercial |
$650.32
|
| Rate for Payer: Cash Price |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.21
|
| Rate for Payer: Healthscope Commercial |
$757.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$715.28
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$513.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.53
|
| Rate for Payer: UHC Core |
$702.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.13
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$841.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$199.86 |
| Max. Negotiated Rate |
$757.36 |
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna Medicare |
$218.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.97
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$210.38
|
| Rate for Payer: BCBS Trust/PPO |
$654.27
|
| Rate for Payer: BCN Commercial |
$654.27
|
| Rate for Payer: BCN Medicare Advantage |
$210.38
|
| Rate for Payer: Cash Price |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.38
|
| Rate for Payer: Healthscope Commercial |
$757.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$715.28
|
| Rate for Payer: PACE Senior Care Partners |
$199.86
|
| Rate for Payer: PACE SWMI |
$210.38
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: PHP Medicare Advantage |
$210.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$732.11
|
| Rate for Payer: Priority Health Medicare |
$210.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$513.24
|
| Rate for Payer: Railroad Medicare Medicare |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.53
|
| Rate for Payer: UHC Core |
$702.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.38
|
| Rate for Payer: UHC Medicare Advantage |
$216.69
|
| Rate for Payer: VA VA |
$210.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.13
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,002.91
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,188.19 |
| Max. Negotiated Rate |
$4,502.62 |
| Rate for Payer: Aetna Commercial |
$4,252.47
|
| Rate for Payer: Aetna Medicare |
$1,300.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,563.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,563.41
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$1,250.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,889.76
|
| Rate for Payer: BCN Commercial |
$3,889.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,250.73
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cofinity Commercial |
$4,302.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,002.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,250.73
|
| Rate for Payer: Healthscope Commercial |
$4,502.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,752.18
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,313.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,438.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,252.47
|
| Rate for Payer: PACE Senior Care Partners |
$1,188.19
|
| Rate for Payer: PACE SWMI |
$1,250.73
|
| Rate for Payer: PHP Commercial |
$4,252.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,250.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,502.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,352.53
|
| Rate for Payer: Priority Health Medicare |
$1,250.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,051.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,250.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,402.56
|
| Rate for Payer: UHC Core |
$4,177.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,250.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.25
|
| Rate for Payer: VA VA |
$1,250.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,752.18
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,002.91
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,051.27 |
| Max. Negotiated Rate |
$4,502.62 |
| Rate for Payer: Aetna Commercial |
$4,252.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,866.25
|
| Rate for Payer: BCN Commercial |
$3,866.25
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cofinity Commercial |
$4,302.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,002.33
|
| Rate for Payer: Healthscope Commercial |
$4,502.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,752.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,252.47
|
| Rate for Payer: PHP Commercial |
$4,252.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,502.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,352.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,051.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,402.56
|
| Rate for Payer: UHC Core |
$4,177.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,752.18
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,349.22
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,262.49 |
| Max. Negotiated Rate |
$4,814.30 |
| Rate for Payer: Aetna Commercial |
$4,546.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,133.88
|
| Rate for Payer: BCN Commercial |
$4,133.88
|
| Rate for Payer: Cash Price |
$4,279.38
|
| Rate for Payer: Cofinity Commercial |
$4,600.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,279.38
|
| Rate for Payer: Healthscope Commercial |
$4,814.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,011.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,546.84
|
| Rate for Payer: PHP Commercial |
$4,546.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,744.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,653.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,262.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,707.31
|
| Rate for Payer: UHC Core |
$4,466.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,011.92
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,349.22
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,270.44 |
| Max. Negotiated Rate |
$4,814.30 |
| Rate for Payer: Aetna Commercial |
$4,546.84
|
| Rate for Payer: Aetna Medicare |
$1,390.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,671.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,671.63
|
| Rate for Payer: BCBS Complete |
$2,139.69
|
| Rate for Payer: BCBS MAPPO |
$1,337.30
|
| Rate for Payer: BCBS Trust/PPO |
$4,159.02
|
| Rate for Payer: BCN Commercial |
$4,159.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,337.30
|
| Rate for Payer: Cash Price |
$4,279.38
|
| Rate for Payer: Cofinity Commercial |
$4,600.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,279.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,337.30
|
| Rate for Payer: Healthscope Commercial |
$4,814.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,011.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,404.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,537.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,546.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,270.44
|
| Rate for Payer: PACE SWMI |
$1,337.30
|
| Rate for Payer: PHP Commercial |
$4,546.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,337.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,744.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,653.82
|
| Rate for Payer: Priority Health Medicare |
$1,337.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,262.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,337.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,707.31
|
| Rate for Payer: UHC Core |
$4,466.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,337.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,377.42
|
| Rate for Payer: VA VA |
$1,337.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,011.92
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$4,321.70
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,026.40 |
| Max. Negotiated Rate |
$3,889.53 |
| Rate for Payer: Aetna Commercial |
$3,673.44
|
| Rate for Payer: Aetna Medicare |
$1,123.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,350.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,350.53
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$1,080.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,360.12
|
| Rate for Payer: BCN Commercial |
$3,360.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,080.42
|
| Rate for Payer: Cash Price |
$3,457.36
|
| Rate for Payer: Cash Price |
$3,457.36
|
| Rate for Payer: Cofinity Commercial |
$3,716.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,457.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,080.42
|
| Rate for Payer: Healthscope Commercial |
$3,889.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,241.28
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,134.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,242.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,673.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,026.40
|
| Rate for Payer: PACE SWMI |
$1,080.42
|
| Rate for Payer: PHP Commercial |
$3,673.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,080.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,025.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,759.88
|
| Rate for Payer: Priority Health Medicare |
$1,080.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,635.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,080.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,803.10
|
| Rate for Payer: UHC Core |
$3,608.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,080.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,112.84
|
| Rate for Payer: VA VA |
$1,080.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,241.28
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$4,321.70
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,635.80 |
| Max. Negotiated Rate |
$3,889.53 |
| Rate for Payer: Aetna Commercial |
$3,673.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.81
|
| Rate for Payer: BCN Commercial |
$3,339.81
|
| Rate for Payer: Cash Price |
$3,457.36
|
| Rate for Payer: Cofinity Commercial |
$3,716.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,457.36
|
| Rate for Payer: Healthscope Commercial |
$3,889.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,241.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,673.44
|
| Rate for Payer: PHP Commercial |
$3,673.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,025.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,759.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,635.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,803.10
|
| Rate for Payer: UHC Core |
$3,608.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,241.28
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,570.00
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$847.88 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna Medicare |
$928.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,115.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,115.62
|
| Rate for Payer: BCBS Complete |
$1,428.00
|
| Rate for Payer: BCBS MAPPO |
$892.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,775.68
|
| Rate for Payer: BCN Commercial |
$2,775.68
|
| Rate for Payer: BCN Medicare Advantage |
$892.50
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.50
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$937.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,034.50
|
| Rate for Payer: PACE Senior Care Partners |
$847.88
|
| Rate for Payer: PACE SWMI |
$892.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: PHP Medicare Advantage |
$892.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,499.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,105.90
|
| Rate for Payer: Priority Health Medicare |
$892.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,177.34
|
| Rate for Payer: Railroad Medicare Medicare |
$892.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.60
|
| Rate for Payer: UHC Core |
$2,980.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.50
|
| Rate for Payer: UHC Medicare Advantage |
$919.28
|
| Rate for Payer: VA VA |
$892.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,570.00
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,177.34 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.90
|
| Rate for Payer: BCN Commercial |
$2,758.90
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,034.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,499.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,105.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,177.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,141.60
|
| Rate for Payer: UHC Core |
$2,980.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,379.21
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,940.18 |
| Max. Negotiated Rate |
$10,241.29 |
| Rate for Payer: Aetna Commercial |
$9,672.33
|
| Rate for Payer: BCBS Trust/PPO |
$8,793.85
|
| Rate for Payer: BCN Commercial |
$8,793.85
|
| Rate for Payer: Cash Price |
$9,103.37
|
| Rate for Payer: Cofinity Commercial |
$9,786.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,103.37
|
| Rate for Payer: Healthscope Commercial |
$10,241.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,534.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,672.33
|
| Rate for Payer: PHP Commercial |
$9,672.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,965.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,899.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,940.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,013.70
|
| Rate for Payer: UHC Core |
$9,501.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,534.41
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,379.21
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,702.56 |
| Max. Negotiated Rate |
$10,241.29 |
| Rate for Payer: Aetna Commercial |
$9,672.33
|
| Rate for Payer: Aetna Medicare |
$2,958.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,556.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,556.00
|
| Rate for Payer: BCBS Complete |
$4,551.68
|
| Rate for Payer: BCBS MAPPO |
$2,844.80
|
| Rate for Payer: BCBS Trust/PPO |
$8,847.34
|
| Rate for Payer: BCN Commercial |
$8,847.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,844.80
|
| Rate for Payer: Cash Price |
$9,103.37
|
| Rate for Payer: Cofinity Commercial |
$9,786.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,103.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,844.80
|
| Rate for Payer: Healthscope Commercial |
$10,241.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,534.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,987.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,271.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,672.33
|
| Rate for Payer: PACE Senior Care Partners |
$2,702.56
|
| Rate for Payer: PACE SWMI |
$2,844.80
|
| Rate for Payer: PHP Commercial |
$9,672.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,844.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,965.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,899.91
|
| Rate for Payer: Priority Health Medicare |
$2,844.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,940.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,844.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,013.70
|
| Rate for Payer: UHC Core |
$9,501.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,844.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,930.15
|
| Rate for Payer: VA VA |
$2,844.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,534.41
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$10,344.74
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,309.26 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: BCBS Trust/PPO |
$7,994.42
|
| Rate for Payer: BCN Commercial |
$7,994.42
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,999.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,309.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,103.37
|
| Rate for Payer: UHC Core |
$8,637.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$10,344.74
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,456.88 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna Medicare |
$2,689.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,232.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,232.73
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$2,586.18
|
| Rate for Payer: BCBS Trust/PPO |
$8,043.04
|
| Rate for Payer: BCN Commercial |
$8,043.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,586.18
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,586.18
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,715.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,974.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PACE Senior Care Partners |
$2,456.88
|
| Rate for Payer: PACE SWMI |
$2,586.18
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,586.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,999.92
|
| Rate for Payer: Priority Health Medicare |
$2,586.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,309.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,586.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,103.37
|
| Rate for Payer: UHC Core |
$8,637.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,586.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,663.77
|
| Rate for Payer: VA VA |
$2,586.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$10,344.74
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,456.88 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna Medicare |
$2,689.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,232.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,232.73
|
| Rate for Payer: BCBS Complete |
$4,927.66
|
| Rate for Payer: BCBS MAPPO |
$2,586.18
|
| Rate for Payer: BCBS Trust/PPO |
$8,043.04
|
| Rate for Payer: BCN Commercial |
$8,043.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,586.18
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,586.18
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Mclaren Medicaid |
$4,693.01
|
| Rate for Payer: Meridian Medicaid |
$4,927.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,715.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,974.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PACE Senior Care Partners |
$2,456.88
|
| Rate for Payer: PACE SWMI |
$2,586.18
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,586.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,693.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,999.92
|
| Rate for Payer: Priority Health Medicare |
$2,586.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,309.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,586.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,103.37
|
| Rate for Payer: UHC Core |
$8,637.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,586.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,663.77
|
| Rate for Payer: VA VA |
$2,586.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$10,344.74
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,309.26 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: BCBS Trust/PPO |
$7,994.42
|
| Rate for Payer: BCN Commercial |
$7,994.42
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,999.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,309.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,103.37
|
| Rate for Payer: UHC Core |
$8,637.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
OP
|
$1,226.49
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.29 |
| Max. Negotiated Rate |
$1,103.84 |
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: Aetna Medicare |
$318.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$383.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$383.28
|
| Rate for Payer: BCBS Complete |
$490.60
|
| Rate for Payer: BCBS MAPPO |
$306.62
|
| Rate for Payer: BCBS Trust/PPO |
$953.60
|
| Rate for Payer: BCN Commercial |
$953.60
|
| Rate for Payer: BCN Medicare Advantage |
$306.62
|
| Rate for Payer: Cash Price |
$981.19
|
| Rate for Payer: Cofinity Commercial |
$1,054.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.62
|
| Rate for Payer: Healthscope Commercial |
$1,103.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,042.52
|
| Rate for Payer: PACE Senior Care Partners |
$291.29
|
| Rate for Payer: PACE SWMI |
$306.62
|
| Rate for Payer: PHP Commercial |
$1,042.52
|
| Rate for Payer: PHP Medicare Advantage |
$306.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.05
|
| Rate for Payer: Priority Health Medicare |
$306.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.04
|
| Rate for Payer: Railroad Medicare Medicare |
$306.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,079.31
|
| Rate for Payer: UHC Core |
$1,024.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.62
|
| Rate for Payer: UHC Medicare Advantage |
$315.82
|
| Rate for Payer: VA VA |
$306.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.87
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
IP
|
$1,226.49
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$748.04 |
| Max. Negotiated Rate |
$1,103.84 |
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: BCBS Trust/PPO |
$947.83
|
| Rate for Payer: BCN Commercial |
$947.83
|
| Rate for Payer: Cash Price |
$981.19
|
| Rate for Payer: Cofinity Commercial |
$1,054.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.19
|
| Rate for Payer: Healthscope Commercial |
$1,103.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,042.52
|
| Rate for Payer: PHP Commercial |
$1,042.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,079.31
|
| Rate for Payer: UHC Core |
$1,024.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.87
|
|
