|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,241.28
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,806.56 |
| Max. Negotiated Rate |
$5,617.15 |
| Rate for Payer: Aetna Commercial |
$5,305.09
|
| Rate for Payer: BCBS Trust/PPO |
$4,823.26
|
| Rate for Payer: BCN Commercial |
$4,823.26
|
| Rate for Payer: Cash Price |
$4,993.02
|
| Rate for Payer: Cofinity Commercial |
$5,367.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,993.02
|
| Rate for Payer: Healthscope Commercial |
$5,617.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,680.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,305.09
|
| Rate for Payer: PHP Commercial |
$5,305.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,368.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,429.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,806.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,492.33
|
| Rate for Payer: UHC Core |
$5,211.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,680.96
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.68 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: BCBS Trust/PPO |
$331.57
|
| Rate for Payer: BCN Commercial |
$331.57
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.90 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$111.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.08
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$107.26
|
| Rate for Payer: BCBS Trust/PPO |
$333.59
|
| Rate for Payer: BCN Commercial |
$333.59
|
| Rate for Payer: BCN Medicare Advantage |
$107.26
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.26
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Senior Care Partners |
$101.90
|
| Rate for Payer: PACE SWMI |
$107.26
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$107.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.27
|
| Rate for Payer: Priority Health Medicare |
$107.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.68
|
| Rate for Payer: Railroad Medicare Medicare |
$107.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.56
|
| Rate for Payer: UHC Core |
$358.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.26
|
| Rate for Payer: UHC Medicare Advantage |
$110.48
|
| Rate for Payer: VA VA |
$107.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$414.20 |
| Max. Negotiated Rate |
$611.21 |
| Rate for Payer: Aetna Commercial |
$577.25
|
| Rate for Payer: BCBS Trust/PPO |
$524.82
|
| Rate for Payer: BCN Commercial |
$524.82
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$584.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Healthscope Commercial |
$611.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: PHP Commercial |
$577.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.63
|
| Rate for Payer: UHC Core |
$567.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.34
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$161.29 |
| Max. Negotiated Rate |
$611.21 |
| Rate for Payer: Aetna Commercial |
$577.25
|
| Rate for Payer: Aetna Medicare |
$176.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.22
|
| Rate for Payer: BCBS Complete |
$322.96
|
| Rate for Payer: BCBS MAPPO |
$169.78
|
| Rate for Payer: BCBS Trust/PPO |
$528.02
|
| Rate for Payer: BCN Commercial |
$528.02
|
| Rate for Payer: BCN Medicare Advantage |
$169.78
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$584.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.78
|
| Rate for Payer: Healthscope Commercial |
$611.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.34
|
| Rate for Payer: Mclaren Medicaid |
$307.58
|
| Rate for Payer: Meridian Medicaid |
$322.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: PACE Senior Care Partners |
$161.29
|
| Rate for Payer: PACE SWMI |
$169.78
|
| Rate for Payer: PHP Commercial |
$577.25
|
| Rate for Payer: PHP Medicare Advantage |
$169.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.83
|
| Rate for Payer: Priority Health Medicare |
$169.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.20
|
| Rate for Payer: Railroad Medicare Medicare |
$169.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.63
|
| Rate for Payer: UHC Core |
$567.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.78
|
| Rate for Payer: UHC Medicare Advantage |
$174.87
|
| Rate for Payer: VA VA |
$169.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.34
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$144.99 |
| Max. Negotiated Rate |
$549.43 |
| Rate for Payer: Aetna Commercial |
$518.91
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.78
|
| Rate for Payer: BCBS Complete |
$322.96
|
| Rate for Payer: BCBS MAPPO |
$152.62
|
| Rate for Payer: BCBS Trust/PPO |
$474.65
|
| Rate for Payer: BCN Commercial |
$474.65
|
| Rate for Payer: BCN Medicare Advantage |
$152.62
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$525.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.62
|
| Rate for Payer: Healthscope Commercial |
$549.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.86
|
| Rate for Payer: Mclaren Medicaid |
$307.58
|
| Rate for Payer: Meridian Medicaid |
$322.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: PACE Senior Care Partners |
$144.99
|
| Rate for Payer: PACE SWMI |
$152.62
|
| Rate for Payer: PHP Commercial |
$518.91
|
| Rate for Payer: PHP Medicare Advantage |
$152.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.12
|
| Rate for Payer: Priority Health Medicare |
$152.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.33
|
| Rate for Payer: Railroad Medicare Medicare |
$152.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.22
|
| Rate for Payer: UHC Core |
$509.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.62
|
| Rate for Payer: UHC Medicare Advantage |
$157.20
|
| Rate for Payer: VA VA |
$152.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.86
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$372.33 |
| Max. Negotiated Rate |
$549.43 |
| Rate for Payer: Aetna Commercial |
$518.91
|
| Rate for Payer: BCBS Trust/PPO |
$471.78
|
| Rate for Payer: BCN Commercial |
$471.78
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$525.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Healthscope Commercial |
$549.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: PHP Commercial |
$518.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.22
|
| Rate for Payer: UHC Core |
$509.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.86
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$65.94 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: BCBS Trust/PPO |
$83.56
|
| Rate for Payer: BCN Commercial |
$83.56
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$28.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.79
|
| Rate for Payer: BCBS Complete |
$50.90
|
| Rate for Payer: BCBS MAPPO |
$27.03
|
| Rate for Payer: BCBS Trust/PPO |
$84.06
|
| Rate for Payer: BCN Commercial |
$84.06
|
| Rate for Payer: BCN Medicare Advantage |
$27.03
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.03
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$48.48
|
| Rate for Payer: Meridian Medicaid |
$50.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PACE Senior Care Partners |
$25.68
|
| Rate for Payer: PACE SWMI |
$27.03
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$27.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.06
|
| Rate for Payer: Priority Health Medicare |
$27.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.94
|
| Rate for Payer: Railroad Medicare Medicare |
$27.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.03
|
| Rate for Payer: UHC Medicare Advantage |
$27.84
|
| Rate for Payer: VA VA |
$27.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$104.94 |
| Rate for Payer: Aetna Commercial |
$99.11
|
| Rate for Payer: Aetna Medicare |
$30.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.44
|
| Rate for Payer: BCBS Complete |
$56.85
|
| Rate for Payer: BCBS MAPPO |
$29.15
|
| Rate for Payer: BCBS Trust/PPO |
$90.66
|
| Rate for Payer: BCN Commercial |
$90.66
|
| Rate for Payer: BCN Medicare Advantage |
$29.15
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$100.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.15
|
| Rate for Payer: Healthscope Commercial |
$104.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.45
|
| Rate for Payer: Mclaren Medicaid |
$54.15
|
| Rate for Payer: Meridian Medicaid |
$56.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: PACE Senior Care Partners |
$27.69
|
| Rate for Payer: PACE SWMI |
$29.15
|
| Rate for Payer: PHP Commercial |
$99.11
|
| Rate for Payer: PHP Medicare Advantage |
$29.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.44
|
| Rate for Payer: Priority Health Medicare |
$29.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.11
|
| Rate for Payer: Railroad Medicare Medicare |
$29.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.61
|
| Rate for Payer: UHC Core |
$97.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.15
|
| Rate for Payer: UHC Medicare Advantage |
$30.02
|
| Rate for Payer: VA VA |
$29.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.45
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.11 |
| Max. Negotiated Rate |
$104.94 |
| Rate for Payer: Aetna Commercial |
$99.11
|
| Rate for Payer: BCBS Trust/PPO |
$90.11
|
| Rate for Payer: BCN Commercial |
$90.11
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$100.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Healthscope Commercial |
$104.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: PHP Commercial |
$99.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.61
|
| Rate for Payer: UHC Core |
$97.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.45
|
|
|
HC Z BALLOON CATHETER
|
Facility
|
IP
|
$1,522.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$928.80 |
| Max. Negotiated Rate |
$1,370.59 |
| Rate for Payer: Aetna Commercial |
$1,294.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.88
|
| Rate for Payer: BCN Commercial |
$1,176.88
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cofinity Commercial |
$1,309.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
| Rate for Payer: Healthscope Commercial |
$1,370.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
| Rate for Payer: PHP Commercial |
$1,294.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,324.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.13
|
| Rate for Payer: UHC Core |
$1,271.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.16
|
|
|
HC Z BALLOON CATHETER
|
Facility
|
OP
|
$1,522.88
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$361.68 |
| Max. Negotiated Rate |
$1,370.59 |
| Rate for Payer: Aetna Commercial |
$1,294.45
|
| Rate for Payer: Aetna Medicare |
$395.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.90
|
| Rate for Payer: BCBS Complete |
$609.15
|
| Rate for Payer: BCBS MAPPO |
$380.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.04
|
| Rate for Payer: BCN Commercial |
$1,184.04
|
| Rate for Payer: BCN Medicare Advantage |
$380.72
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cofinity Commercial |
$1,309.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.72
|
| Rate for Payer: Healthscope Commercial |
$1,370.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$399.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
| Rate for Payer: PACE Senior Care Partners |
$361.68
|
| Rate for Payer: PACE SWMI |
$380.72
|
| Rate for Payer: PHP Commercial |
$1,294.45
|
| Rate for Payer: PHP Medicare Advantage |
$380.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,324.91
|
| Rate for Payer: Priority Health Medicare |
$380.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.80
|
| Rate for Payer: Railroad Medicare Medicare |
$380.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.13
|
| Rate for Payer: UHC Core |
$1,271.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.72
|
| Rate for Payer: UHC Medicare Advantage |
$392.14
|
| Rate for Payer: VA VA |
$380.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.16
|
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
OP
|
$5,380.54
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,277.88 |
| Max. Negotiated Rate |
$4,842.49 |
| Rate for Payer: Aetna Commercial |
$4,573.46
|
| Rate for Payer: Aetna Medicare |
$1,398.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,681.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,681.42
|
| Rate for Payer: BCBS Complete |
$2,152.22
|
| Rate for Payer: BCBS MAPPO |
$1,345.14
|
| Rate for Payer: BCBS Trust/PPO |
$4,183.37
|
| Rate for Payer: BCN Commercial |
$4,183.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,345.14
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cofinity Commercial |
$4,627.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,345.14
|
| Rate for Payer: Healthscope Commercial |
$4,842.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,035.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,412.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,546.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
| Rate for Payer: PACE Senior Care Partners |
$1,277.88
|
| Rate for Payer: PACE SWMI |
$1,345.14
|
| Rate for Payer: PHP Commercial |
$4,573.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,345.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,681.07
|
| Rate for Payer: Priority Health Medicare |
$1,345.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,281.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,345.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,734.88
|
| Rate for Payer: UHC Core |
$4,492.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,345.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,385.49
|
| Rate for Payer: VA VA |
$1,345.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,035.40
|
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
IP
|
$5,380.54
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,281.59 |
| Max. Negotiated Rate |
$4,842.49 |
| Rate for Payer: Aetna Commercial |
$4,573.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,158.08
|
| Rate for Payer: BCN Commercial |
$4,158.08
|
| Rate for Payer: Cash Price |
$4,304.43
|
| Rate for Payer: Cofinity Commercial |
$4,627.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
| Rate for Payer: Healthscope Commercial |
$4,842.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,035.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
| Rate for Payer: PHP Commercial |
$4,573.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,681.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,281.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,734.88
|
| Rate for Payer: UHC Core |
$4,492.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,035.40
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,017.54
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,450.30 |
| Max. Negotiated Rate |
$3,615.79 |
| Rate for Payer: Aetna Commercial |
$3,414.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,104.75
|
| Rate for Payer: BCN Commercial |
$3,104.75
|
| Rate for Payer: Cash Price |
$3,214.03
|
| Rate for Payer: Cofinity Commercial |
$3,455.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
| Rate for Payer: Healthscope Commercial |
$3,615.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,013.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
| Rate for Payer: PHP Commercial |
$3,414.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,495.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,450.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,535.44
|
| Rate for Payer: UHC Core |
$3,354.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,013.16
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,017.54
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$954.17 |
| Max. Negotiated Rate |
$3,615.79 |
| Rate for Payer: Aetna Commercial |
$3,414.91
|
| Rate for Payer: Aetna Medicare |
$1,044.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,255.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,255.48
|
| Rate for Payer: BCBS Complete |
$1,607.02
|
| Rate for Payer: BCBS MAPPO |
$1,004.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,123.64
|
| Rate for Payer: BCN Commercial |
$3,123.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,004.38
|
| Rate for Payer: Cash Price |
$3,214.03
|
| Rate for Payer: Cofinity Commercial |
$3,455.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,004.38
|
| Rate for Payer: Healthscope Commercial |
$3,615.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,013.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,054.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,155.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
| Rate for Payer: PACE Senior Care Partners |
$954.17
|
| Rate for Payer: PACE SWMI |
$1,004.38
|
| Rate for Payer: PHP Commercial |
$3,414.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,004.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,495.26
|
| Rate for Payer: Priority Health Medicare |
$1,004.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,450.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,004.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,535.44
|
| Rate for Payer: UHC Core |
$3,354.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,004.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,034.52
|
| Rate for Payer: VA VA |
$1,004.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,013.16
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,541.41
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,791.08 |
| Max. Negotiated Rate |
$6,787.27 |
| Rate for Payer: Aetna Commercial |
$6,410.20
|
| Rate for Payer: Aetna Medicare |
$1,960.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,356.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,356.69
|
| Rate for Payer: BCBS Complete |
$3,016.56
|
| Rate for Payer: BCBS MAPPO |
$1,885.35
|
| Rate for Payer: BCBS Trust/PPO |
$5,863.45
|
| Rate for Payer: BCN Commercial |
$5,863.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,885.35
|
| Rate for Payer: Cash Price |
$6,033.13
|
| Rate for Payer: Cofinity Commercial |
$6,485.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,885.35
|
| Rate for Payer: Healthscope Commercial |
$6,787.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,656.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,979.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,168.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,791.08
|
| Rate for Payer: PACE SWMI |
$1,885.35
|
| Rate for Payer: PHP Commercial |
$6,410.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,885.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,561.03
|
| Rate for Payer: Priority Health Medicare |
$1,885.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,599.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,885.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,636.44
|
| Rate for Payer: UHC Core |
$6,297.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,885.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,941.91
|
| Rate for Payer: VA VA |
$1,885.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,656.06
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,541.41
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,599.51 |
| Max. Negotiated Rate |
$6,787.27 |
| Rate for Payer: Aetna Commercial |
$6,410.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,828.00
|
| Rate for Payer: BCN Commercial |
$5,828.00
|
| Rate for Payer: Cash Price |
$6,033.13
|
| Rate for Payer: Cofinity Commercial |
$6,485.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
| Rate for Payer: Healthscope Commercial |
$6,787.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,656.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
| Rate for Payer: PHP Commercial |
$6,410.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,561.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,599.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,636.44
|
| Rate for Payer: UHC Core |
$6,297.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,656.06
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,185.41
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,332.88 |
| Max. Negotiated Rate |
$1,966.87 |
| Rate for Payer: Aetna Commercial |
$1,857.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.88
|
| Rate for Payer: BCN Commercial |
$1,688.88
|
| Rate for Payer: Cash Price |
$1,748.33
|
| Rate for Payer: Cofinity Commercial |
$1,879.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
| Rate for Payer: Healthscope Commercial |
$1,966.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
| Rate for Payer: PHP Commercial |
$1,857.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,901.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,332.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,923.16
|
| Rate for Payer: UHC Core |
$1,824.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,639.06
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,185.41
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$519.03 |
| Max. Negotiated Rate |
$1,966.87 |
| Rate for Payer: Aetna Commercial |
$1,857.60
|
| Rate for Payer: Aetna Medicare |
$568.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.94
|
| Rate for Payer: BCBS Complete |
$874.16
|
| Rate for Payer: BCBS MAPPO |
$546.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,699.16
|
| Rate for Payer: BCN Commercial |
$1,699.16
|
| Rate for Payer: BCN Medicare Advantage |
$546.35
|
| Rate for Payer: Cash Price |
$1,748.33
|
| Rate for Payer: Cofinity Commercial |
$1,879.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.35
|
| Rate for Payer: Healthscope Commercial |
$1,966.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,639.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$573.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
| Rate for Payer: PACE Senior Care Partners |
$519.03
|
| Rate for Payer: PACE SWMI |
$546.35
|
| Rate for Payer: PHP Commercial |
$1,857.60
|
| Rate for Payer: PHP Medicare Advantage |
$546.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,901.31
|
| Rate for Payer: Priority Health Medicare |
$546.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,332.88
|
| Rate for Payer: Railroad Medicare Medicare |
$546.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,923.16
|
| Rate for Payer: UHC Core |
$1,824.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.35
|
| Rate for Payer: UHC Medicare Advantage |
$562.74
|
| Rate for Payer: VA VA |
$546.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,639.06
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$60,748.42
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$37,050.46 |
| Max. Negotiated Rate |
$54,673.58 |
| Rate for Payer: Aetna Commercial |
$51,636.16
|
| Rate for Payer: BCBS Trust/PPO |
$46,946.38
|
| Rate for Payer: BCN Commercial |
$46,946.38
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cofinity Commercial |
$52,243.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
| Rate for Payer: Healthscope Commercial |
$54,673.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,561.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
| Rate for Payer: PHP Commercial |
$51,636.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52,851.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,050.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,458.61
|
| Rate for Payer: UHC Core |
$50,724.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,561.32
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$60,748.42
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$14,427.75 |
| Max. Negotiated Rate |
$54,673.58 |
| Rate for Payer: Aetna Commercial |
$51,636.16
|
| Rate for Payer: Aetna Medicare |
$15,794.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,983.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,983.88
|
| Rate for Payer: BCBS Complete |
$50,737.80
|
| Rate for Payer: BCBS MAPPO |
$15,187.10
|
| Rate for Payer: BCBS Trust/PPO |
$47,231.90
|
| Rate for Payer: BCN Commercial |
$47,231.90
|
| Rate for Payer: BCN Medicare Advantage |
$15,187.10
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cash Price |
$48,598.74
|
| Rate for Payer: Cofinity Commercial |
$52,243.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,187.10
|
| Rate for Payer: Healthscope Commercial |
$54,673.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,561.32
|
| Rate for Payer: Mclaren Medicaid |
$48,321.72
|
| Rate for Payer: Meridian Medicaid |
$50,737.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,946.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,465.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
| Rate for Payer: PACE Senior Care Partners |
$14,427.75
|
| Rate for Payer: PACE SWMI |
$15,187.10
|
| Rate for Payer: PHP Commercial |
$51,636.16
|
| Rate for Payer: PHP Medicare Advantage |
$15,187.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$48,321.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52,851.13
|
| Rate for Payer: Priority Health Medicare |
$15,187.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,050.46
|
| Rate for Payer: Railroad Medicare Medicare |
$15,187.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,458.61
|
| Rate for Payer: UHC Core |
$50,724.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,187.10
|
| Rate for Payer: UHC Medicare Advantage |
$15,642.72
|
| Rate for Payer: VA VA |
$15,187.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,561.32
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,500.87
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$915.38 |
| Max. Negotiated Rate |
$1,350.78 |
| Rate for Payer: Aetna Commercial |
$1,275.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.87
|
| Rate for Payer: BCN Commercial |
$1,159.87
|
| Rate for Payer: Cash Price |
$1,200.70
|
| Rate for Payer: Cofinity Commercial |
$1,290.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
| Rate for Payer: Healthscope Commercial |
$1,350.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
| Rate for Payer: PHP Commercial |
$1,275.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,305.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$915.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.77
|
| Rate for Payer: UHC Core |
$1,253.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.65
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,500.87
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$356.46 |
| Max. Negotiated Rate |
$1,350.78 |
| Rate for Payer: Aetna Commercial |
$1,275.74
|
| Rate for Payer: Aetna Medicare |
$390.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$469.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$469.02
|
| Rate for Payer: BCBS Complete |
$600.35
|
| Rate for Payer: BCBS MAPPO |
$375.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.93
|
| Rate for Payer: BCN Commercial |
$1,166.93
|
| Rate for Payer: BCN Medicare Advantage |
$375.22
|
| Rate for Payer: Cash Price |
$1,200.70
|
| Rate for Payer: Cofinity Commercial |
$1,290.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.22
|
| Rate for Payer: Healthscope Commercial |
$1,350.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$393.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
| Rate for Payer: PACE Senior Care Partners |
$356.46
|
| Rate for Payer: PACE SWMI |
$375.22
|
| Rate for Payer: PHP Commercial |
$1,275.74
|
| Rate for Payer: PHP Medicare Advantage |
$375.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,305.76
|
| Rate for Payer: Priority Health Medicare |
$375.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$915.38
|
| Rate for Payer: Railroad Medicare Medicare |
$375.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.77
|
| Rate for Payer: UHC Core |
$1,253.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.22
|
| Rate for Payer: UHC Medicare Advantage |
$386.47
|
| Rate for Payer: VA VA |
$375.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.65
|
|
