|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
OP
|
$5,164.84
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,226.65 |
| Max. Negotiated Rate |
$4,648.36 |
| Rate for Payer: Aetna Commercial |
$4,390.11
|
| Rate for Payer: Aetna Medicare |
$1,342.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,614.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,614.01
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$1,291.21
|
| Rate for Payer: BCBS Trust/PPO |
$4,246.01
|
| Rate for Payer: BCN Commercial |
$4,015.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.21
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cofinity Commercial |
$4,441.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,131.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.21
|
| Rate for Payer: Healthscope Commercial |
$4,648.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,873.63
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.77
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,484.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,390.11
|
| Rate for Payer: Nomi Health Commercial |
$4,235.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,226.65
|
| Rate for Payer: PACE SWMI |
$1,291.21
|
| Rate for Payer: PHP Commercial |
$4,390.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,357.15
|
| Rate for Payer: Priority Health HMO/PPO |
$4,493.41
|
| Rate for Payer: Priority Health Medicare |
$1,304.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,460.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,291.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,545.06
|
| Rate for Payer: UHC Core |
$4,312.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.21
|
| Rate for Payer: UHC Exchange |
$1,291.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,291.21
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$1,291.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,873.63
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
IP
|
$5,164.84
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,357.15 |
| Max. Negotiated Rate |
$4,648.36 |
| Rate for Payer: Aetna Commercial |
$4,390.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,216.06
|
| Rate for Payer: BCN Commercial |
$3,991.39
|
| Rate for Payer: Cash Price |
$4,131.87
|
| Rate for Payer: Cofinity Commercial |
$4,441.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,131.87
|
| Rate for Payer: Healthscope Commercial |
$4,648.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,873.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,390.11
|
| Rate for Payer: Nomi Health Commercial |
$4,235.17
|
| Rate for Payer: PHP Commercial |
$4,390.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,357.15
|
| Rate for Payer: Priority Health HMO/PPO |
$4,493.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,460.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,545.06
|
| Rate for Payer: UHC Core |
$4,312.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,873.63
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.34 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$59.45
|
| Rate for Payer: BCN Commercial |
$56.28
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.34
|
| Rate for Payer: Priority Health HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$56.63
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.34
|
| Rate for Payer: Priority Health HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.80
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.21
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
IP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,165.69 |
| Max. Negotiated Rate |
$12,690.95 |
| Rate for Payer: Aetna Commercial |
$11,985.90
|
| Rate for Payer: BCBS Trust/PPO |
$11,510.70
|
| Rate for Payer: BCN Commercial |
$10,897.30
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$12,126.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Healthscope Commercial |
$12,690.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,575.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: Nomi Health Commercial |
$11,562.87
|
| Rate for Payer: PHP Commercial |
$11,985.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: Priority Health HMO/PPO |
$12,267.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,447.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,408.93
|
| Rate for Payer: UHC Core |
$11,774.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,575.80
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
OP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,349.00 |
| Max. Negotiated Rate |
$12,690.95 |
| Rate for Payer: Aetna Commercial |
$11,985.90
|
| Rate for Payer: Aetna Medicare |
$3,666.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,406.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,406.58
|
| Rate for Payer: BCBS Complete |
$4,881.81
|
| Rate for Payer: BCBS MAPPO |
$3,525.26
|
| Rate for Payer: BCBS Trust/PPO |
$11,592.48
|
| Rate for Payer: BCN Commercial |
$10,963.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,525.26
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$12,126.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,525.26
|
| Rate for Payer: Healthscope Commercial |
$12,690.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,575.80
|
| Rate for Payer: Mclaren Medicaid |
$4,649.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,701.53
|
| Rate for Payer: Meridian Medicaid |
$4,881.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,054.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: Nomi Health Commercial |
$11,562.87
|
| Rate for Payer: PACE Senior Care Partners |
$3,349.00
|
| Rate for Payer: PACE SWMI |
$3,525.26
|
| Rate for Payer: PHP Commercial |
$11,985.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,525.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,649.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: Priority Health HMO/PPO |
$12,267.92
|
| Rate for Payer: Priority Health Medicare |
$3,560.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,447.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3,525.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,408.93
|
| Rate for Payer: UHC Core |
$11,774.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,525.26
|
| Rate for Payer: UHC Exchange |
$3,525.26
|
| Rate for Payer: UHC Medicare Advantage |
$3,525.26
|
| Rate for Payer: UHCCP Medicaid |
$4,649.03
|
| Rate for Payer: VA VA |
$3,525.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,575.80
|
|
|
HC PERCLOSE
|
Facility
|
IP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$683.95 |
| Max. Negotiated Rate |
$947.01 |
| Rate for Payer: Aetna Commercial |
$894.40
|
| Rate for Payer: BCBS Trust/PPO |
$858.94
|
| Rate for Payer: BCN Commercial |
$813.16
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$904.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Healthscope Commercial |
$947.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: Nomi Health Commercial |
$862.83
|
| Rate for Payer: PHP Commercial |
$894.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: Priority Health HMO/PPO |
$915.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.96
|
| Rate for Payer: UHC Core |
$878.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.17
|
|
|
HC PERCLOSE
|
Facility
|
OP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.90 |
| Max. Negotiated Rate |
$947.01 |
| Rate for Payer: Aetna Commercial |
$894.40
|
| Rate for Payer: Aetna Medicare |
$273.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.82
|
| Rate for Payer: BCBS Complete |
$420.89
|
| Rate for Payer: BCBS MAPPO |
$263.06
|
| Rate for Payer: BCBS Trust/PPO |
$865.04
|
| Rate for Payer: BCN Commercial |
$818.11
|
| Rate for Payer: BCN Medicare Advantage |
$263.06
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$904.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.06
|
| Rate for Payer: Healthscope Commercial |
$947.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: Nomi Health Commercial |
$862.83
|
| Rate for Payer: PACE Senior Care Partners |
$249.90
|
| Rate for Payer: PACE SWMI |
$263.06
|
| Rate for Payer: PHP Commercial |
$894.40
|
| Rate for Payer: PHP Medicare Advantage |
$263.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: Priority Health HMO/PPO |
$915.44
|
| Rate for Payer: Priority Health Medicare |
$265.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$704.99
|
| Rate for Payer: Railroad Medicare Medicare |
$263.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.96
|
| Rate for Payer: UHC Core |
$878.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.06
|
| Rate for Payer: UHC Exchange |
$263.06
|
| Rate for Payer: UHC Medicare Advantage |
$263.06
|
| Rate for Payer: VA VA |
$263.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.17
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,231.07 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: BCBS Trust/PPO |
$5,313.57
|
| Rate for Payer: BCN Commercial |
$5,030.42
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,545.97 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$1,692.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,034.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,034.17
|
| Rate for Payer: BCBS Complete |
$4,241.07
|
| Rate for Payer: BCBS MAPPO |
$1,627.34
|
| Rate for Payer: BCBS Trust/PPO |
$5,351.33
|
| Rate for Payer: BCN Commercial |
$5,061.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,627.34
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,627.34
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.00
|
| Rate for Payer: Mclaren Medicaid |
$4,038.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,708.70
|
| Rate for Payer: Meridian Medicaid |
$4,241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,871.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: Nomi Health Commercial |
$5,337.66
|
| Rate for Payer: PACE Senior Care Partners |
$1,545.97
|
| Rate for Payer: PACE SWMI |
$1,627.34
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,627.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,038.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.13
|
| Rate for Payer: Priority Health Medicare |
$1,643.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,627.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,728.22
|
| Rate for Payer: UHC Core |
$5,435.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,627.34
|
| Rate for Payer: UHC Exchange |
$1,627.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,627.34
|
| Rate for Payer: UHCCP Medicaid |
$4,038.85
|
| Rate for Payer: VA VA |
$1,627.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.00
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,500.15 |
| Max. Negotiated Rate |
$15,923.29 |
| Rate for Payer: Aetna Commercial |
$15,038.66
|
| Rate for Payer: BCBS Trust/PPO |
$14,442.42
|
| Rate for Payer: BCN Commercial |
$13,672.79
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$15,215.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Healthscope Commercial |
$15,923.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,269.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: Nomi Health Commercial |
$14,507.88
|
| Rate for Payer: PHP Commercial |
$15,038.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: Priority Health HMO/PPO |
$15,392.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,854.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,569.44
|
| Rate for Payer: UHC Core |
$14,773.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,269.40
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,201.98 |
| Max. Negotiated Rate |
$15,923.29 |
| Rate for Payer: Aetna Commercial |
$15,038.66
|
| Rate for Payer: Aetna Medicare |
$4,600.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,528.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,528.92
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$4,423.14
|
| Rate for Payer: BCBS Trust/PPO |
$14,545.04
|
| Rate for Payer: BCN Commercial |
$13,755.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,423.14
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$15,215.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,423.14
|
| Rate for Payer: Healthscope Commercial |
$15,923.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,269.40
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,644.29
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,086.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: Nomi Health Commercial |
$14,507.88
|
| Rate for Payer: PACE Senior Care Partners |
$4,201.98
|
| Rate for Payer: PACE SWMI |
$4,423.14
|
| Rate for Payer: PHP Commercial |
$15,038.66
|
| Rate for Payer: PHP Medicare Advantage |
$4,423.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: Priority Health HMO/PPO |
$15,392.51
|
| Rate for Payer: Priority Health Medicare |
$4,467.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,854.00
|
| Rate for Payer: Railroad Medicare Medicare |
$4,423.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,569.44
|
| Rate for Payer: UHC Core |
$14,773.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,423.14
|
| Rate for Payer: UHC Exchange |
$4,423.14
|
| Rate for Payer: UHC Medicare Advantage |
$4,423.14
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$4,423.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,269.40
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,261.94 |
| Max. Negotiated Rate |
$25,285.76 |
| Rate for Payer: Aetna Commercial |
$23,881.00
|
| Rate for Payer: BCBS Trust/PPO |
$22,934.19
|
| Rate for Payer: BCN Commercial |
$21,712.04
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$24,161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Healthscope Commercial |
$25,285.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,071.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: Nomi Health Commercial |
$23,038.14
|
| Rate for Payer: PHP Commercial |
$23,881.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: Priority Health HMO/PPO |
$24,442.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,823.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,723.86
|
| Rate for Payer: UHC Core |
$23,459.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,071.47
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,672.63 |
| Max. Negotiated Rate |
$25,285.76 |
| Rate for Payer: Aetna Commercial |
$23,881.00
|
| Rate for Payer: Aetna Medicare |
$7,304.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,779.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,779.78
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$7,023.82
|
| Rate for Payer: BCBS Trust/PPO |
$23,097.14
|
| Rate for Payer: BCN Commercial |
$21,844.09
|
| Rate for Payer: BCN Medicare Advantage |
$7,023.82
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$24,161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,023.82
|
| Rate for Payer: Healthscope Commercial |
$25,285.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,071.47
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,375.01
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,077.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: Nomi Health Commercial |
$23,038.14
|
| Rate for Payer: PACE Senior Care Partners |
$6,672.63
|
| Rate for Payer: PACE SWMI |
$7,023.82
|
| Rate for Payer: PHP Commercial |
$23,881.00
|
| Rate for Payer: PHP Medicare Advantage |
$7,023.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: Priority Health HMO/PPO |
$24,442.90
|
| Rate for Payer: Priority Health Medicare |
$7,094.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,823.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,023.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,723.86
|
| Rate for Payer: UHC Core |
$23,459.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,023.82
|
| Rate for Payer: UHC Exchange |
$7,023.82
|
| Rate for Payer: UHC Medicare Advantage |
$7,023.82
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$7,023.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,071.47
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: BCBS Trust/PPO |
$11.18
|
| Rate for Payer: BCN Commercial |
$10.58
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: Priority Health HMO/PPO |
$11.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.05
|
| Rate for Payer: UHC Core |
$11.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.27
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna Medicare |
$3.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.28
|
| Rate for Payer: BCBS Complete |
$5.48
|
| Rate for Payer: BCBS MAPPO |
$3.42
|
| Rate for Payer: BCBS Trust/PPO |
$11.25
|
| Rate for Payer: BCN Commercial |
$10.64
|
| Rate for Payer: BCN Medicare Advantage |
$3.42
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.42
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Nomi Health Commercial |
$11.23
|
| Rate for Payer: PACE Senior Care Partners |
$3.25
|
| Rate for Payer: PACE SWMI |
$3.42
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: PHP Medicare Advantage |
$3.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: Priority Health HMO/PPO |
$11.91
|
| Rate for Payer: Priority Health Medicare |
$3.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.05
|
| Rate for Payer: UHC Core |
$11.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.42
|
| Rate for Payer: UHC Exchange |
$3.42
|
| Rate for Payer: UHC Medicare Advantage |
$3.42
|
| Rate for Payer: VA VA |
$3.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.27
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,949.72 |
| Max. Negotiated Rate |
$4,084.23 |
| Rate for Payer: Aetna Commercial |
$3,857.33
|
| Rate for Payer: BCBS Trust/PPO |
$3,704.39
|
| Rate for Payer: BCN Commercial |
$3,506.99
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$3,902.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Healthscope Commercial |
$4,084.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,403.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: Nomi Health Commercial |
$3,721.18
|
| Rate for Payer: PHP Commercial |
$3,857.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,948.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,993.47
|
| Rate for Payer: UHC Core |
$3,789.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,403.52
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,077.78 |
| Max. Negotiated Rate |
$4,084.23 |
| Rate for Payer: Aetna Commercial |
$3,857.33
|
| Rate for Payer: Aetna Medicare |
$1,179.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,418.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,418.13
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$1,134.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,730.71
|
| Rate for Payer: BCN Commercial |
$3,528.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.51
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$3,902.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.51
|
| Rate for Payer: Healthscope Commercial |
$4,084.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,403.52
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,191.23
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,304.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: Nomi Health Commercial |
$3,721.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,077.78
|
| Rate for Payer: PACE SWMI |
$1,134.51
|
| Rate for Payer: PHP Commercial |
$3,857.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,948.09
|
| Rate for Payer: Priority Health Medicare |
$1,145.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,134.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,993.47
|
| Rate for Payer: UHC Core |
$3,789.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,134.51
|
| Rate for Payer: UHC Exchange |
$1,134.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,134.51
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$1,134.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,403.52
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
OP
|
$6,525.68
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,549.85 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: Aetna Medicare |
$1,696.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,039.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,039.28
|
| Rate for Payer: BCBS Complete |
$2,610.27
|
| Rate for Payer: BCBS MAPPO |
$1,631.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,364.76
|
| Rate for Payer: BCN Commercial |
$5,073.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,631.42
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,631.42
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,712.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,876.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,549.85
|
| Rate for Payer: PACE SWMI |
$1,631.42
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,631.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health HMO/PPO |
$5,677.34
|
| Rate for Payer: Priority Health Medicare |
$1,647.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,372.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,631.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,742.60
|
| Rate for Payer: UHC Core |
$5,448.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,631.42
|
| Rate for Payer: UHC Exchange |
$1,631.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,631.42
|
| Rate for Payer: VA VA |
$1,631.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
IP
|
$6,525.68
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,241.69 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,326.91
|
| Rate for Payer: BCN Commercial |
$5,043.05
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health HMO/PPO |
$5,677.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,372.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,742.60
|
| Rate for Payer: UHC Core |
$5,448.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
OP
|
$2,545.27
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.50 |
| Max. Negotiated Rate |
$2,290.74 |
| Rate for Payer: Aetna Commercial |
$2,163.48
|
| Rate for Payer: Aetna Medicare |
$661.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$795.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$795.40
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$636.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.47
|
| Rate for Payer: BCN Commercial |
$1,978.95
|
| Rate for Payer: BCN Medicare Advantage |
$636.32
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cofinity Commercial |
$2,188.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.32
|
| Rate for Payer: Healthscope Commercial |
$2,290.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.95
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.13
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$731.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.48
|
| Rate for Payer: Nomi Health Commercial |
$2,087.12
|
| Rate for Payer: PACE Senior Care Partners |
$604.50
|
| Rate for Payer: PACE SWMI |
$636.32
|
| Rate for Payer: PHP Commercial |
$2,163.48
|
| Rate for Payer: PHP Medicare Advantage |
$636.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.43
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.38
|
| Rate for Payer: Priority Health Medicare |
$642.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.33
|
| Rate for Payer: Railroad Medicare Medicare |
$636.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.84
|
| Rate for Payer: UHC Core |
$2,125.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.32
|
| Rate for Payer: UHC Exchange |
$636.32
|
| Rate for Payer: UHC Medicare Advantage |
$636.32
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$636.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.95
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,545.27
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,654.43 |
| Max. Negotiated Rate |
$2,290.74 |
| Rate for Payer: Aetna Commercial |
$2,163.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.70
|
| Rate for Payer: BCN Commercial |
$1,966.98
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cofinity Commercial |
$2,188.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.22
|
| Rate for Payer: Healthscope Commercial |
$2,290.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.48
|
| Rate for Payer: Nomi Health Commercial |
$2,087.12
|
| Rate for Payer: PHP Commercial |
$2,163.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.43
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,239.84
|
| Rate for Payer: UHC Core |
$2,125.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.95
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$103.24
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$24.52 |
| Max. Negotiated Rate |
$92.92 |
| Rate for Payer: Aetna Commercial |
$87.75
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$84.87
|
| Rate for Payer: BCN Commercial |
$80.27
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cofinity Commercial |
$88.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$92.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.43
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.75
|
| Rate for Payer: Nomi Health Commercial |
$84.66
|
| Rate for Payer: PACE Senior Care Partners |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$87.75
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.11
|
| Rate for Payer: Priority Health HMO/PPO |
$89.82
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.17
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.85
|
| Rate for Payer: UHC Core |
$86.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Exchange |
$25.81
|
| Rate for Payer: UHC Medicare Advantage |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.43
|
|
