|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$257.08
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$61.06 |
| Max. Negotiated Rate |
$231.37 |
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: Aetna Medicare |
$66.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.34
|
| Rate for Payer: BCBS Complete |
$102.83
|
| Rate for Payer: BCBS MAPPO |
$64.27
|
| Rate for Payer: BCBS Trust/PPO |
$199.88
|
| Rate for Payer: BCN Commercial |
$199.88
|
| Rate for Payer: BCN Medicare Advantage |
$64.27
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cofinity Commercial |
$221.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.27
|
| Rate for Payer: Healthscope Commercial |
$231.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.52
|
| Rate for Payer: PACE Senior Care Partners |
$61.06
|
| Rate for Payer: PACE SWMI |
$64.27
|
| Rate for Payer: PHP Commercial |
$218.52
|
| Rate for Payer: PHP Medicare Advantage |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.66
|
| Rate for Payer: Priority Health Medicare |
$64.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.79
|
| Rate for Payer: Railroad Medicare Medicare |
$64.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.23
|
| Rate for Payer: UHC Core |
$214.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$66.20
|
| Rate for Payer: VA VA |
$64.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.81
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$257.08
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$156.79 |
| Max. Negotiated Rate |
$231.37 |
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: BCBS Trust/PPO |
$198.67
|
| Rate for Payer: BCN Commercial |
$198.67
|
| Rate for Payer: Cash Price |
$205.66
|
| Rate for Payer: Cofinity Commercial |
$221.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.66
|
| Rate for Payer: Healthscope Commercial |
$231.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.52
|
| Rate for Payer: PHP Commercial |
$218.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.23
|
| Rate for Payer: UHC Core |
$214.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.81
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$19.28
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$17.35 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: BCBS Trust/PPO |
$14.90
|
| Rate for Payer: BCN Commercial |
$14.90
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.42
|
| Rate for Payer: Healthscope Commercial |
$17.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.39
|
| Rate for Payer: PHP Commercial |
$16.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.97
|
| Rate for Payer: UHC Core |
$16.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.46
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$19.28
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$17.35 |
| Rate for Payer: Aetna Commercial |
$16.39
|
| Rate for Payer: Aetna Medicare |
$5.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: BCBS Complete |
$2.82
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$14.99
|
| Rate for Payer: BCN Commercial |
$14.99
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cofinity Commercial |
$16.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$17.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.46
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Meridian Medicaid |
$2.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.39
|
| Rate for Payer: PACE Senior Care Partners |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$16.39
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.77
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.97
|
| Rate for Payer: UHC Core |
$16.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Medicare Advantage |
$4.96
|
| Rate for Payer: VA VA |
$4.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.46
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$17.78
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$17.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$201.96
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.18 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: BCBS Trust/PPO |
$156.07
|
| Rate for Payer: BCN Commercial |
$156.07
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.67
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.72
|
| Rate for Payer: UHC Core |
$168.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$201.96
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$181.76 |
| Rate for Payer: Aetna Commercial |
$171.67
|
| Rate for Payer: Aetna Medicare |
$52.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.11
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$50.49
|
| Rate for Payer: BCBS Trust/PPO |
$157.02
|
| Rate for Payer: BCN Commercial |
$157.02
|
| Rate for Payer: BCN Medicare Advantage |
$50.49
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cash Price |
$161.57
|
| Rate for Payer: Cofinity Commercial |
$173.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.49
|
| Rate for Payer: Healthscope Commercial |
$181.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.47
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.67
|
| Rate for Payer: PACE Senior Care Partners |
$47.97
|
| Rate for Payer: PACE SWMI |
$50.49
|
| Rate for Payer: PHP Commercial |
$171.67
|
| Rate for Payer: PHP Medicare Advantage |
$50.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.71
|
| Rate for Payer: Priority Health Medicare |
$50.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.18
|
| Rate for Payer: Railroad Medicare Medicare |
$50.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.72
|
| Rate for Payer: UHC Core |
$168.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.49
|
| Rate for Payer: UHC Medicare Advantage |
$52.00
|
| Rate for Payer: VA VA |
$50.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.47
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Aetna Commercial |
$79.90
|
| Rate for Payer: Aetna Medicare |
$24.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.38
|
| Rate for Payer: BCBS Complete |
$17.78
|
| Rate for Payer: BCBS MAPPO |
$23.50
|
| Rate for Payer: BCBS Trust/PPO |
$73.08
|
| Rate for Payer: BCN Commercial |
$73.08
|
| Rate for Payer: BCN Medicare Advantage |
$23.50
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$80.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.50
|
| Rate for Payer: Healthscope Commercial |
$84.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.50
|
| Rate for Payer: Mclaren Medicaid |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$17.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.90
|
| Rate for Payer: PACE Senior Care Partners |
$22.32
|
| Rate for Payer: PACE SWMI |
$23.50
|
| Rate for Payer: PHP Commercial |
$79.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.78
|
| Rate for Payer: Priority Health Medicare |
$23.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.33
|
| Rate for Payer: Railroad Medicare Medicare |
$23.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.72
|
| Rate for Payer: UHC Core |
$78.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.50
|
| Rate for Payer: UHC Medicare Advantage |
$24.20
|
| Rate for Payer: VA VA |
$23.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.50
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.33 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Aetna Commercial |
$79.90
|
| Rate for Payer: BCBS Trust/PPO |
$72.64
|
| Rate for Payer: BCN Commercial |
$72.64
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$80.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.20
|
| Rate for Payer: Healthscope Commercial |
$84.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.90
|
| Rate for Payer: PHP Commercial |
$79.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.72
|
| Rate for Payer: UHC Core |
$78.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.50
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna Medicare |
$32.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.52
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$98.34
|
| Rate for Payer: BCN Commercial |
$98.34
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.51
|
| Rate for Payer: PACE Senior Care Partners |
$30.04
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.04
|
| Rate for Payer: Priority Health Medicare |
$31.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.14
|
| Rate for Payer: Railroad Medicare Medicare |
$31.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.30
|
| Rate for Payer: UHC Core |
$105.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.62
|
| Rate for Payer: UHC Medicare Advantage |
$32.57
|
| Rate for Payer: VA VA |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$126.48
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$77.14 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: BCBS Trust/PPO |
$97.74
|
| Rate for Payer: BCN Commercial |
$97.74
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.51
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.30
|
| Rate for Payer: UHC Core |
$105.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$95.88
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna Medicare |
$24.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.96
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$23.97
|
| Rate for Payer: BCBS Trust/PPO |
$74.55
|
| Rate for Payer: BCN Commercial |
$74.55
|
| Rate for Payer: BCN Medicare Advantage |
$23.97
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.97
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.50
|
| Rate for Payer: PACE Senior Care Partners |
$22.77
|
| Rate for Payer: PACE SWMI |
$23.97
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: PHP Medicare Advantage |
$23.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.42
|
| Rate for Payer: Priority Health Medicare |
$23.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.48
|
| Rate for Payer: Railroad Medicare Medicare |
$23.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.37
|
| Rate for Payer: UHC Core |
$80.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.97
|
| Rate for Payer: UHC Medicare Advantage |
$24.69
|
| Rate for Payer: VA VA |
$23.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$95.88
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.48 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: BCBS Trust/PPO |
$74.10
|
| Rate for Payer: BCN Commercial |
$74.10
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.50
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.37
|
| Rate for Payer: UHC Core |
$80.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$127.50
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: Aetna Medicare |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.84
|
| Rate for Payer: BCBS Complete |
$17.78
|
| Rate for Payer: BCBS MAPPO |
$31.88
|
| Rate for Payer: BCBS Trust/PPO |
$99.13
|
| Rate for Payer: BCN Commercial |
$99.13
|
| Rate for Payer: BCN Medicare Advantage |
$31.88
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.88
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Mclaren Medicaid |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$17.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.38
|
| Rate for Payer: PACE Senior Care Partners |
$30.28
|
| Rate for Payer: PACE SWMI |
$31.88
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: PHP Medicare Advantage |
$31.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.92
|
| Rate for Payer: Priority Health Medicare |
$31.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.76
|
| Rate for Payer: Railroad Medicare Medicare |
$31.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.20
|
| Rate for Payer: UHC Core |
$106.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.88
|
| Rate for Payer: UHC Medicare Advantage |
$32.83
|
| Rate for Payer: VA VA |
$31.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$127.50
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$77.76 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: BCBS Trust/PPO |
$98.53
|
| Rate for Payer: BCN Commercial |
$98.53
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.38
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.20
|
| Rate for Payer: UHC Core |
$106.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$75.63 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Aetna Commercial |
$105.40
|
| Rate for Payer: BCBS Trust/PPO |
$95.83
|
| Rate for Payer: BCN Commercial |
$95.83
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$106.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.20
|
| Rate for Payer: Healthscope Commercial |
$111.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.40
|
| Rate for Payer: PHP Commercial |
$105.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.12
|
| Rate for Payer: UHC Core |
$103.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.00
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$111.60 |
| Rate for Payer: Aetna Commercial |
$105.40
|
| Rate for Payer: Aetna Medicare |
$32.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.75
|
| Rate for Payer: BCBS Complete |
$17.78
|
| Rate for Payer: BCBS MAPPO |
$31.00
|
| Rate for Payer: BCBS Trust/PPO |
$96.41
|
| Rate for Payer: BCN Commercial |
$96.41
|
| Rate for Payer: BCN Medicare Advantage |
$31.00
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$106.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.00
|
| Rate for Payer: Healthscope Commercial |
$111.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.00
|
| Rate for Payer: Mclaren Medicaid |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$17.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.40
|
| Rate for Payer: PACE Senior Care Partners |
$29.45
|
| Rate for Payer: PACE SWMI |
$31.00
|
| Rate for Payer: PHP Commercial |
$105.40
|
| Rate for Payer: PHP Medicare Advantage |
$31.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.88
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.63
|
| Rate for Payer: Railroad Medicare Medicare |
$31.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.12
|
| Rate for Payer: UHC Core |
$103.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.00
|
| Rate for Payer: UHC Medicare Advantage |
$31.93
|
| Rate for Payer: VA VA |
$31.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.00
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.01 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$21.01
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$20.01
|
| Rate for Payer: Meridian Medicaid |
$21.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,850.06 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,025.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,434.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,434.29
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,947.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,056.52
|
| Rate for Payer: BCN Commercial |
$6,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.44
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.44
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,044.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,239.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,850.06
|
| Rate for Payer: PACE SWMI |
$1,947.44
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Medicare |
$1,947.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,947.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,005.86
|
| Rate for Payer: VA VA |
$1,947.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,750.96 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,019.91
|
| Rate for Payer: BCN Commercial |
$6,019.91
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC WALL STENT
|
Facility
|
IP
|
$5,979.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,646.86 |
| Max. Negotiated Rate |
$5,381.50 |
| Rate for Payer: Aetna Commercial |
$5,082.52
|
| Rate for Payer: BCBS Trust/PPO |
$4,620.91
|
| Rate for Payer: BCN Commercial |
$4,620.91
|
| Rate for Payer: Cash Price |
$4,783.55
|
| Rate for Payer: Cofinity Commercial |
$5,142.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,783.55
|
| Rate for Payer: Healthscope Commercial |
$5,381.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,484.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,082.52
|
| Rate for Payer: PHP Commercial |
$5,082.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,185.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,202.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,646.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,261.91
|
| Rate for Payer: UHC Core |
$4,992.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,484.58
|
|
|
HC WALL STENT
|
Facility
|
OP
|
$5,979.44
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,420.12 |
| Max. Negotiated Rate |
$5,381.50 |
| Rate for Payer: Aetna Commercial |
$5,082.52
|
| Rate for Payer: Aetna Medicare |
$1,554.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,868.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,868.58
|
| Rate for Payer: BCBS Complete |
$2,391.78
|
| Rate for Payer: BCBS MAPPO |
$1,494.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,649.01
|
| Rate for Payer: BCN Commercial |
$4,649.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,494.86
|
| Rate for Payer: Cash Price |
$4,783.55
|
| Rate for Payer: Cofinity Commercial |
$5,142.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,783.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,494.86
|
| Rate for Payer: Healthscope Commercial |
$5,381.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,484.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,569.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,719.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,082.52
|
| Rate for Payer: PACE Senior Care Partners |
$1,420.12
|
| Rate for Payer: PACE SWMI |
$1,494.86
|
| Rate for Payer: PHP Commercial |
$5,082.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,494.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,185.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,202.11
|
| Rate for Payer: Priority Health Medicare |
$1,494.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,646.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,494.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,261.91
|
| Rate for Payer: UHC Core |
$4,992.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,494.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,539.71
|
| Rate for Payer: VA VA |
$1,494.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,484.58
|
|
|
HC WALNUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
